Acceptance and commitment therapy for schizophrenia and psychosis inpatients with recovery and experience orientation (ASPIRE): A qualitative study of participant experiences

This uncontrolled study aims to gather a comprehensive understanding of participants' experiences during an inpatient intervention specialized in the treatment of psychotic disorders, embedded in a holistic therapeutic ward-concept rooted in acceptance and commitment therapy (ACT), extending its isolated delivery in group therapies. Particular attention was paid to participants' perceptions of the concept, the mechanisms of impact they described and the transfer of therapy-related experiences into daily life.

A qualitative study design was used to evaluate experiences.

Thirty semi-structured interviews were conducted with inpatients with psychosis upon completing the intervention. Following a later protocol amendment, 11 complementary follow-up interviews were conducted. All were audio-recorded and transcribed. A Straussian grounded theory-informed content structuring analysis was carried out to create a comprehensive coding scheme.

Participants regarded the general concept as fostering for their personal development, emphasizing positive interactions with staff and other inpatients, while pointing out structural barriers. Group therapies were perceived as highly relevant, engaging and practical in nature. Reported impacts represent the established ACT-domains 'open', 'aware' and 'active'. Meaningful transfers to daily life were prevalent at both times of interviews, and participants generally displayed an optimistic and life-oriented attitude half a year upon completion.

The holistic therapeutic concept appears to succeed in impactfully conveying the principles of ACT. Findings suggest that through including the entire ward staff as ACT-therapists, it promotes therapeutic alliance and interpersonal connectedness to a particular degree. Participants highlighted the hands-on and guiding nature of therapy contents as especially motivating, leading to meaningful change.