Acceptance and Commitment Therapy for individuals at risk for psychosis or with a first psychotic episode: A qualitative study on patients' perspectives

Abstract

AimThe aim of this qualitative study is to explore patients' perspectives on Acceptance and Commitment Therapy for early stages of psychosis. Therefore, we interviewed participants of the INTERACT study, that quantitatively investigated Acceptance and Commitment Therapy in Daily Life (ACT‐DL) in combination with treatment as usual, for early stages of psychosis, comparing it to treatment as usual.MethodsWithin 6 months after finishing ACT‐DL, we conducted semi‐structured, individual interviews with 19 participants. All interviews were audio‐recorded and transcribed. Thematic analysis was used for coding and analysis.ResultsTwo overarching themes were formed: ‘the meaning of ACT’ and ‘what to improve’. Considering the first, participants generally understood and connected with the meaning of ACT, noticing more awareness and acceptance of their thoughts and feelings, and living more in line with their personal values. The second theme included comments on the protocol not being personal or psychosis specific enough and some elements of ACT being too difficult to understand when having active psychotic symptoms.ConclusionsThis study suggests that ACT is an acceptable and promising new form of treatment for early stages of psychosis, and it provides relevant information to further develop ACT for this group.

How Does Individual Psychotherapy Promote Recovery for Persons with Psychosis? A Systematic Review of Qualitative Studies to Understand the Patient’s Experience

“…There were N = 33 studies that met inclusion criteria presented in Table 1 [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ]. Publication years ranged from 2003–2023.…”

“…There were three studies that analyzed Metacognitive Reflection and Insight Therapy (MERIT) [ 40 , 52 , 54 ]. There were three studies that analyzed Acceptance and Commitment Therapy (ACT) [ 32 , 37 , 39 ] and one with compassionate imagery [ 43 ]. Several additional studies involved a form of trauma therapy, including one study each of eye movement desensitization and reprocessing EMDR [ 41 ], trauma-focused imaginal exposure [ 42 ], prolonged exposure [ 47 ], narrative exposure therapy [ 55 ], and two studies including trauma-integrated psychotherapy for psychosis (TRIPP) [ 61 , 62 ].…”

“…There were twelve studies which included a broader population of serious mental illness that included additional diagnoses (e.g., depression with psychotic features or post-traumatic stress disorder) along with psychosis [ 31 , 39 , 41 , 42 , 46 , 47 , 55 , 57 , 58 , 59 , 61 , 62 ]. One study included individuals with clinical high risk in addition to the individuals with early psychosis that fit inclusion criteria, thus it was included in the analysis [ 37 ]. The majority of studies were conducted in the United Kingdom [ 31 , 33 , 35 , 38 , 39 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 53 , 56 , 60 , 63 ], followed by Australia [ 32 , 42 , 61 , 62 ], the United States [ 36 , 47 , 52 , 54 ], The Netherlands [ 37 , 40 , 55 ], Norway [ 34 , 59 ], Germany [ 58 ], New Zealand [ 41 ], and South Africa [ 57 ].…”

“…One study included individuals with clinical high risk in addition to the individuals with early psychosis that fit inclusion criteria, thus it was included in the analysis [ 37 ]. The majority of studies were conducted in the United Kingdom [ 31 , 33 , 35 , 38 , 39 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 53 , 56 , 60 , 63 ], followed by Australia [ 32 , 42 , 61 , 62 ], the United States [ 36 , 47 , 52 , 54 ], The Netherlands [ 37 , 40 , 55 ], Norway [ 34 , 59 ], Germany [ 58 ], New Zealand [ 41 ], and South Africa [ 57 ]. The number of study participants ranged from four to twenty-five.…”

Value Component of Acceptance and Commitment Therapy (ACT) among Patients with Schizophrenia

“…ACT has been shown to be effective in reducing symptoms of anxiety and depression in patients with schizophrenia [15]. However, there is limited research on the use of ACT as the main intervention for patients with schizophrenia [16]. It is possible that ACT could be implemented after other interventions such as CBT, cognitive remediation therapy (CRT), or rehabilitation programs [17].…”