Acceptance and commitment therapy compared to treatment as usual in psychosis: A systematic review and meta-analysis
Open accessAbstract
Introduction: Schizophrenia and psychotic disorders are chronic conditions. Although antipsychotic medications are the first line of treatment, many patients continued to have symptoms. Acceptance and Commitment Therapy (ACT) is a therapy that applies mindfulness to teach patients accepting the existence of symptoms rather than avoid them. A meta-analysis was conducted to measure the efficacy of ACT in treatment of Methods: A systematic review search was conducted using the following keywords: acceptance and commitment therapy, randomized, clinical trials, psychosis, schizophrenia, and major depressive disorder AND psychosis. All studies were read by two authors and checked for eligibility. Studies were included if randomly allocate to ACT or usual treatment (TAU), and psychosis as diagnosis. Mantel and Haenszel approach was used to determine the heterogeneity in the study. For quantitative outcomes, standardized mean difference between ACT and TAU was used to summarize effect size, while relative risk was used for categorical outcomes along with 95% confidence interval. Results: 217 studies were identified. 92 studies were selected for review after removing the duplications. A total of 4 studies were included in quantitative-synthesis. The mean age for the participants was 38 years of age. Regarding treatment outcomes, there was a significant difference between the two arms in the degree of change of negative symptoms (p=0.008), but the difference was not significant for positive symptoms. There was a reduction of re-hospitalization rate at 4 months in ACT compared to TAU in participants with Conclusions: ACT is a promising adjunctive therapy for patient with
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In only one meta-analysis specifically for positive psychosis symptomatology, there was a non-significant negligible effect in favor of the TAU control group compared to ACT (Tonarelli et al., 2016).
“In only one meta-analysis specifically for positive psychosis symptom atology there was a non-significant negligible effect in favor of the TAU control group compared to ACT (Tonarelli et al., 2016).”
From The empirical status of acceptance and commitment therapy: A review of meta-analyses (2020) · cites this paper as Tonarelli et al., 2016
The 13 meta-analytic effects comparing ACT to TAU reported effect sizes ranging from no effect g = 0.15 to medium g = 0.79.
“The thirteen meta-analytic effects comparing ACT to TAU reported effects sizes ranging from no effect g = 0.15 (Tonarelli et al., 2016) to medium g = 0.79 ( ¨ Ost, 2014).”
From The empirical status of acceptance and commitment therapy: A review of meta-analyses (2020) · cites this paper as Tonarelli et al., 2016
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- Authors
- Tonarelli, S. B., & Pasillas, R.
- ORCID
- Tonarelli, Silvina B
- Venue
- Journal of psychiatry
- Publisher
- OMICS Publishing Group
- Published
- 2016
- Volume
- 19
- Issue
- 03
- ISSN
- 2378-5756 (ISSN-L)
- OpenAlex
- W2414306903
- Cited by
- 38
- References
- 44
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 8 · 2022: 5 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 1
- FWCI
- 3.13
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of psychiatry (publishedVersion, cc-by)
- 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, usual care, negative symptoms, positive symptoms, hospital readmission, adjunctive therapy, mindfulness, antipsychotic drugs
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