The active therapeutic processes of acceptance and commitment therapy for persistent symptoms of psychosis: clients’ perspectives
Abstract
BACKGROUND: There is limited research on the applicability and effectiveness of Acceptance and Commitment Therapy (ACT) for people experiencing psychotic disorders. Clinical trials suggest ACT may be efficacious in reducing distress and rehospitalization rates in psychosis. Mindfulness and reduced literal believability of thought content have been associated with reduced distress for this population. AIMS: To better understand ACT for psychosis, this study investigated clients' perspectives of the hypothesized active therapeutic processes of ACT. METHOD: Semi‑structured interviews, conducted with nine adults diagnosed with schizophrenia or schizoaffective disorder and persistent positive symptoms, were analysed thematically. RESULTS: Four themes emerged: Usefulness of therapy; Changes attributed to ACT; Understanding of therapy; and Non-specific therapy factors. All participants found therapy useful and recommended ACT. Mindfulness, defusion, acceptance and values work were described as the most useful therapy components and contributing to positive changes. Self-rated frequency of symptoms did not change; however a reduction in the intensity and distress associated with symptoms was reported. Non-specific therapy factors were deemed useful by participants but not directly related to outcome. CONCLUSIONS: These findings are consistent with the theoretically defined underlying active processes of ACT and are relevant for this population. The findings also indicate important clinical implications for ACT for this client group: greater attention to the client connecting metaphors and concepts to the intended meaning may be valuable; caution should be used with some mindfulness and defusion techniques for intense experiences; and values work may be particularly useful for this population.
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Although most qualitative studies of adults mentioned values as a helpful component in treatment, contact with the present moment was highlighted and experienced as the most critical and significant core process.
“Although most qualitative studies of adults mentioned values as a helpful component in treatment, contact with the present moment was highlighted and experienced as the most critical and significant core process (Bacon et al., 2014; Davies et al., 2019; Bahattab and AlHadi, 2021).”
From “And I Can Remind Myself That I Am All Of This”: adolescents’ experiences of group-based acceptance and commitment therapy (2024) · cites this paper as Bacon et al., 2014
Bacon et al. (2014) also noted that some adult participants with a psychosis diagnosis also found some of the exercises more comical than helpful.
“Interestingly, Bacon et al. (2014) also noted that some adult participants with a psychosis diagnosis also found some of the exercises more comical than helpful.”
From “And I Can Remind Myself That I Am All Of This”: adolescents’ experiences of group-based acceptance and commitment therapy (2024) · cites this paper as Bacon et al., 2014
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- Authors
- Bacon, T., Farhall, J., & Fossey, E.
- Affiliations
- La Trobe University (AU)
- Corresponding author
- Farhall, John
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-03-21
- Volume
- 42
- Issue
- 4
- Pages
- 402-420
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2086658903
- Cited by
- 36
- References
- 72
- Citations by year
- 2024: 5 · 2023: 5 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 1 · 2015: 3 · 2014: 1 · 2013: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, psychosis, schizophrenia, schizoaffective disorder, therapeutic process, customer perspective, mindfulness, defusion, acceptance, values work, symptom distress
- MeSH terms
- Adaptation, Psychological, Adult, Delusions, Emotions, Female, Hallucinations, Humans, Interview, Psychological, Male, Patient Acceptance of Health Care, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Psychotherapeutic Processes, Thinking, Patient Satisfaction, Qualitative Research, Diagnostic Self Evaluation, Acceptance and Commitment Therapy
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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