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Acceptance and commitment therapy for psychosis: Randomised controlled trial

  • Frances Shawyer (a1), John Farhall (a2), Neil Thomas (a3), Steven C. Hayes (a4), Robert Gallop (a5), David Copolov (a6) and David J. Castle (a7)...
Abstract
Background

The efficacy of acceptance and commitment therapy (ACT) in psychosis has been reported but not for medication-resistant psychosis.

Aims

To test the efficacy of ACT in a sample of community-residing patients with persisting psychotic symptoms. (Australian New Zealand Clinical Trials Registry: ACTRN12608000210370.)

Method

The primary outcome was overall mental state at post-therapy (Positive and Negative Syndrome Scale –total); secondary outcomes were psychotic symptom dimensions and functioning. In total, 96 patients were randomised to ACT (n = 49) or befriending (n = 47). Symptom, functioning and process measures were administered at baseline, post-therapy and 6 months later.

Results

There was no group difference on overall mental state. In secondary analyses the ACT group showed greater improvement in positive symptoms and hallucination distress at follow-up: Cohen's d = 0.52 (95% CI 0.07–0.98) and 0.65 (95% CI 0.24–1.06), respectively.

Conclusions

Improvements reflected the treatment focus on positive symptoms; however, absence of process-measure changes suggests that the ACT intervention used did not manipulate targeted processes beyond befriending. Symptom-specific therapy refinements, improved investigation of process and attention to cognitive functioning and dose are warranted in future research.

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Copyright
Corresponding author
John Farhall, School of Psychology and Public Health, La Trobe University, Victoria 3086, Australia. Email: j.farhall@latrobe.edu.au
Footnotes
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Declaration of interest

None.

Footnotes
References
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Acceptance and commitment therapy for psychosis: Randomised controlled trial

  • Frances Shawyer (a1), John Farhall (a2), Neil Thomas (a3), Steven C. Hayes (a4), Robert Gallop (a5), David Copolov (a6) and David J. Castle (a7)...
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