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  • 1Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.

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Summary
This summary is machine-generated.

Acceptance and Commitment Therapy (ACT) showed benefits for positive symptoms and hallucination distress in patients with persistent psychosis. However, overall mental state did not differ between ACT and befriending groups.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Research

Background:

  • Acceptance and Commitment Therapy (ACT) has demonstrated efficacy in psychosis.
  • Evidence for ACT's effectiveness in medication-resistant psychosis is limited.
  • This study addresses the gap in understanding ACT's utility for persistent psychotic symptoms.

Purpose of the Study:

  • To evaluate the efficacy of Acceptance and Commitment Therapy (ACT) in community-residing patients with persistent psychotic symptoms.
  • To assess ACT's impact on overall mental state, psychotic symptom dimensions, and patient functioning.
  • To compare ACT against a befriending control condition.

Main Methods:

  • A randomized controlled trial (ACTRN12608000210370) involving 96 patients with persisting psychotic symptoms.
  • Participants were randomized to either ACT (n=49) or a befriending control group (n=47).
  • Outcomes, including the Positive and Negative Syndrome Scale (PANSS), were measured at baseline, post-therapy, and 6-month follow-up.

Main Results:

  • No significant group difference was observed in the primary outcome of overall mental state (PANSS total score).
  • The ACT group demonstrated significantly greater improvement in positive symptoms (Cohen's d = 0.52) and reduced hallucination distress (Cohen's d = 0.65) at follow-up.
  • These improvements were specific to symptom dimensions targeted by the therapy.

Conclusions:

  • ACT may offer benefits for specific positive symptoms and distress associated with psychosis, beyond general befriending.
  • The current ACT intervention did not appear to significantly alter targeted psychological processes compared to befriending.
  • Future research should refine ACT interventions, investigate underlying mechanisms, and consider cognitive functioning and dosage for individuals with persistent psychosis.