Korean J Schizophr Res.  2022 Apr;25(1):17-21. 10.16946/kjsr.2022.25.1.17.

Acceptance and Commitment Therapy for Psychosis

• Na E

• KMID: 2529647
• DOI: http://doi.org/10.16946/kjsr.2022.25.1.17

Abstract

There has been increasing interest in the psychosocial treatment of psychosis based on Acceptance and Commitment Therapy (ACT), which has the primary aim of helping people more effectively engage in their lives guided by their values. The approach includes various techniques to change one’s relationship to private experiences, such as hallucination and delusion, rather than rectifying the contents of these experiences. Using the six core processes of the ACT model (hexaflex) tailored to the characteristics of people with psychosis may help alleviate their distress from the symptoms and shape pragmatic value-consistent behaviors. This review introduces the ACT model of psychosis and illustrates the specific ways of applying ACT to people with psychotic experiences.

Keyword

Acceptance and commitment therapy; Psychosis; Psychological flexibility; Schizophrenia; Third wave cognitive behavioral therapy; 수용전념치료; 심리적 유연성; 정신병; 제3동향 인지행동치료; 조현병

Figure

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  Fig. 1. The hexaflex model of psychopathology (psychological inflexibility) and psychological flexibility applied to people with psychosis (adapted from Hayes et al., 2011[10]).

Reference

1. Arciniegas DB. Psychosis. Continuum (Minneap Minn). 2015; 21(3 Behavioral Neurology and Neuropsychiatry):715–736.

2. Foussias G, Remington G. Antipsychotics and schizophrenia: from efficacy and effectiveness to clinical decision-making. Can J Psychiatry. 2010; 55:117–125.

3. Thomas N, Shawyer F, Castle DJ, Copolov D, Hayes SC, Farhall J. A randomised controlled trial of acceptance and commitment therapy (ACT) for psychosis: study protocol. BMC psychiatry. 2014; 14:1–11.

4. Bach P, Hayes SC. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. J Consult Clin Psychol. 2002; 70:1129.

5. Naeem F, Kingdon D, Turkington D. Predictors of response to cognitive behaviour therapy in the treatment of schizophrenia: a comparison of brief and standard interventions. Cognit Ther Res. 2008; 32:651–656.

6. National Institute for Clinical Excellence: Schizophrenia. London: NICE;2002.

7. Gaudiano BA, Herbert JD. Acute treatment of inpatients with psychotic symptoms using Acceptance and Commitment Therapy: Pilot results. Behav Res Ther. 2006; 44:415–437.

8. Society of Clinical Psychology. Acceptance and Commitment Therapy for Psychosis. Available from: http://www.div12.org/psychological-treatments/treatments/acceptance-and-commitment-therapy-for-psychosis.

9. White R, Gumley A, McTaggart J, Rattrie L, McConville D, Cleare S, et al. A feasibility study of Acceptance and Commitment Therapy for emotional dysfunction following psychosis. Behav Res Ther. 2011; 49:901–907.

10. Hayes SC, Strosahl KD, Wilson KG. Psychologial flexibility as a unified model of human functioning. In : Hayes SC, Strosahl KD, Wilson KG, editors. Acceptance and commitment therapy: the process and practice of mindful change. 2nd ed. New York, NY: Guilford Press;2011. p. 60–99.

11. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther. 2004; 35:639–665.

12. Bach P. ACT with the Seriously Mentally Ill. In : Hayes SC, Strosahl KD, editors. A practical guide to acceptance and commitment therapy. New York, NY: Springer;2004. p. 185–208.

13. Thomas N, Morris EM, Shawyer F, Farhall J. Acceptance and commitment therapy for voices. In : Morris EM, Johns LC, Oliver JE, editors. Acceptance and commitment therapy and mindfulness for psychosis. New York, NY: John Wiley & Sons;2013. p. 95–111.

14. Montes JM, Álvarez MP, Garcelán SP. Acceptance and Commitment Therapy for delusions. In : Morris EM, Johns LC, Oliver JE, editors. Acceptance and commitment therapy and mindfulness for psychosis. New York, NY: John Wiley & Sons;2013. p. 112–128.

15. Butler L, Johns LC, Byrne M, Joseph C, O’Donoghue E, Jolley S, et al. Running acceptance and commitment therapy groups for psychosis in community settings. Journal of Contextual Behavioral Science. 2016; 5:33–38.

16. Oliver JE, Joseph C, Byrne M, Johns LC, Morris EM. Introduction to mindfulness and acceptance-based therapies for psychosis. In : Morris EM, Johns LC, Oliver JE, editors. Acceptance and commitment therapy and mindfulness for psychosis. New York, NY: John Wiley & Sons;2013. p. 1–11.

17. Bach P. Acceptance and commitment therapy case formulation. In : Morris EM, Johns LC, Oliver JE, editors. Acceptance and commitment therapy and mindfulness for psychosis. New York, NY: John Wiley & Sons;2013. p. 64–75.

18. Gaudiano BA, Busch AM. Engaging people with psychosis in acceptance and commitment therapy and mindfulness. In : Morris EM, Johns LC, Oliver JE, editors. Acceptance and commitment therapy and mindfulness for psychosis. New York, NY: John Wiley & Sons;2013. p. 76–94.

19. Wilson KG, Sandoz EK, Kitchens J, Roberts M. The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. Psychol Rec. 2010; 60:249–272.

20. Veiga-Martínez C, Pérez-Álvarez M, García-Montes JM. Acceptance and commitment therapy applied to treatment of auditory hallucinations. Clin Case Stud. 2008; 7:118–135.

21. Hayes SC, Strosahl KD, Wilson KG. Taking your mind for a walk exercise. Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change. New York, NY: Guilford Press;1999. p. 162–163.

22. Bach P, Gaudiano BA, Hayes SC, Herbert JD. Acceptance and commitment therapy for psychosis: intent to treat, hospitalization outcome and mediation by believability. Psychosis. 2013; 5:166–174.