A randomised controlled trial of acceptance and commitment therapy (ACT) for psychosis: study protocol

Area of Science:

• Psychiatry and Mental Health
• Clinical Psychology
• Psychological Interventions

Background:

• Cognitive Behavior Therapy (CBT) for psychosis, while prominent, faces challenges in delivery and has shown mixed results in rigorous trials.
• Acceptance and Commitment Therapy (ACT) presents a promising, briefer alternative for psychosis treatment but requires robust evaluation.
• This trial addresses the need for evidence on ACT's efficacy in managing distress and disability in chronic, treatment-resistant psychosis.

Purpose of the Study:

• To evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) in reducing distress and disability associated with psychotic symptoms.
• To compare ACT with an active control condition (Befriending) in a community-residing patient sample.
• To assess the impact of ACT on overall mental state, symptom preoccupation, conviction, distress, and life disruption.

Main Methods:

• A single-blind, multi-centre randomized controlled trial comparing ACT with Befriending.
• Participants with continuous residual hallucinations or delusions for at least six months despite antipsychotic medication were recruited.
• Primary outcome: overall mental state (Positive and Negative Syndrome Scale). Secondary outcomes: symptom-specific measures, social functioning, and service utilization. Assessments at end-of-treatment and 6-month follow-up.

Main Results:

• This section is not available in the provided abstract.

Conclusions:

• This protocol outlines the first randomized controlled trial of ACT for chronic, medication-resistant psychosis using an active comparison.
• The rigorous design aims to provide a definitive test of ACT's mechanism of action and clinical efficacy in this patient group.
• Findings will inform the potential integration of ACT into standard care for individuals with persistent psychotic symptoms.