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Acceptance and Commitment Therapy for Psychosis. What’s the evidence?

Published online by Cambridge University Press:  01 September 2022

F. Azevedo*
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry, Lisbon, Portugal
R. André
Affiliation:
Centro Hospitalar Universitário Lisboa Norte, Psychiatry, Lisboa, Portugal
L. Silva
Affiliation:
Unidade Local de Saúde do Baixo Alentejo, Psychiatry, Beja, Portugal
R. Medinas
Affiliation:
Centro Hospitalar de Lisboa Ocidental, Psychiatry, Lisbon, Portugal
C. Almeida
Affiliation:
NOVA Medical School, Psychiatry And Mental Health, Lisboa, Portugal
*
*Corresponding author.

Abstract

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Introduction

Cognitive behavioural therapy for psychosis as an adjuvant to pharmacological treatment has been been shown to be one of the most effective interventions for schizophrenia with benefits noted in even treatment resistant schizophrenia. Benefits have been mostly registered in the positive symptoms domain of schizophrenia. Acceptance and commitment therapy is a third generation Cognitive-Behavioural Therapy, empirically supported for a range of symptoms and conditions, including psychosis, with quickly increasing data. It targets experiential avoidance, which seems to be closely related with psychopathology. Its ability to also target affective symptoms can be an important advantage in the adjuvant treatment of psychosis.

Objectives

To critically review the evidence of acceptance and commitment therapy in psychosis.

Methods

Non-systematic review of the literature with selection of scientific articles published in the past 10 years; by searching Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: “schizophrenia”, “acceptance and commitment therapy”.

Results

Very few studies have been published on ACT and psychosis, with even less controlled trials and systematic reviews. So far there is convincing evidence for ACT reducing the frequency of hallucinations, increasing the outcomes of traumatic events associated with psychosis and having measurable effects on anxiety and help seeking behaviour.

Conclusions

As Acceptance and Commitment therapy evolves and more evidence arises a new kind of therapy with possible effects on both affective and positive symptoms in schizophrenia can emerge, allowing us to know what works for patients with psychosis and through what mechanisms and permitting the improvement of treatment strategies.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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