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By Todd Schmenk
As someone who approaches therapy through the lens of Functional Contextualism and Relational Frame Theory (RFT), I’ve long questioned the utility of traditional diagnostic frameworks and the reliance on syndromes or clusters of symptoms to define psychological problems. While these approaches can provide a common language for practitioners, they often fail to capture the complexities of human suffering and behavior.
In my experience, psychological struggles are not best understood as discrete categories or disorders but rather as patterns of behavior emerging from an individual’s unique historical and situational context. These patterns are often shaped by attempts to control or avoid internal experiences—thoughts, emotions, sensations—that feel overwhelming, uncomfortable, or unacceptable. While these strategies can offer temporary relief, they often come at a cost, creating cycles of avoidance and disconnection from what matters most.
This is where Acceptance and Commitment Therapy (ACT) offers a refreshing and more effective alternative. Grounded in Functional Contextualism, ACT shifts the focus from symptom elimination to understanding the function of behavior. Instead of asking, “What is wrong with this person?” we ask, “What purpose is this behavior serving in this person’s life?” This approach allows us to see behavior as an attempt to adapt to life’s challenges, even when it leads to outcomes that perpetuate suffering.
Relational Frame Theory deepens this understanding by exploring how language and thought create rigid associations—or relational frames—that can amplify suffering. For example, when someone forms a strong frame around the idea of “failure,” it can influence how they interpret every experience, making it difficult to take risks or pursue meaningful goals. ACT provides tools to help clients step back from these frames, seeing their thoughts and emotions as just that—thoughts and emotions, not absolute truths.
One of the key principles of ACT is psychological flexibility, which involves the ability to stay present, open up to internal experiences, and take action guided by deeply held values. Rather than fighting against their thoughts and feelings, clients learn to work with them, finding new ways to respond that align with what truly matters in their lives. This shift from control to acceptance allows for greater freedom and resilience.
This perspective also challenges the dominant diagnostic models like the DSM-5. While these systems aim to categorize and label, they often overlook the context and function of behavior. This can lead to overdiagnosis, overtreatment, and interventions that fail to address the root of the problem. Steven Hayes, Ph.D., the founder of ACT, has proposed the Psychological Flexibility Model as a more contextually driven alternative. By focusing on fostering flexibility and values-based living, this model offers a path toward meaningful, sustainable change.
In my work, I have seen firsthand how this shift in perspective can transform the therapeutic process. When we focus on the broader context of behavior and help clients step out of rigid relational patterns, we create space for growth, connection, and purpose. The goal is not just to alleviate symptoms but to empower clients to build lives that are rich, full, and meaningful.
More importantly, we can make this shift using the knowledge and experience we already possess. There’s no need to abandon everything we’ve studied or completely redefine ourselves as ACT therapists. The principles of Functional Contextualism and the processes emphasized in ACT—such as acceptance, mindfulness, and values-based action—are not exclusive to a single therapeutic model.
They can be integrated seamlessly into the frameworks we’re already using. By focusing on the underlying processes that drive psychological flexibility and considering the context and function of behavior, we can enhance the effectiveness of our current approaches without discarding our foundational training. This is not about replacing what we know but about enriching it, allowing us to shift our focus in ways that empower our clients to create meaningful and fulfilling lives.
If we truly want to help people flourish, we must move beyond symptom clusters and embrace approaches that honor the complexity of human behavior. By grounding our work in Functional Contextualism and leveraging the insights of Relational Frame Theory, we can better address the root causes of suffering and support clients in creating lives that align with their values.
Let’s rethink the way we approach psychological struggles—not as a collection of symptoms to manage, but as opportunities to understand, grow, and thrive.
Todd Schmenk
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