Assessing the Effectiveness of Acceptance and Commitment Therapy for Distress Following Psychosis
Condition: Psychosis; Schizophrenia; Bipolar Disorder; Schizo-affective Disorder
MeSH terms: Schizophrenia; Bipolar Disorder; Psychotic Disorders; Mental Disorders; Mood Disorders
Study type: Interventional

Summary: 
      This research investigates a new talking therapy aimed at helping people to come to terms
      with the experience of psychosis. The new therapy is called Acceptance and Commitment Therapy
      for psychosis (PACT). PACT aims to help people:

        1. Develop a sense of "mindfulness." Mindfulness allows you to be fully aware of your
           here-and-now experience, with an attitude of openness and curiosity. It is hoped that
           this will help reduce the impact of painful thoughts and feelings.

        2. Take effective action that is conscious and deliberate, rather than impulsive. It is
           hoped that this will allow people to be motivated, guided, and inspired by the things
           that they value in life.

      It is hoped that PACT will help to reduce the level of distress that individuals diagnosed
      with psychosis have been experiencing and help them to stay well in the future.
    

Detailed description: 
      Emphasis has been placed on treating the 'positive symptoms' of psychosis (e.g.
      hallucinations and delusions). Concordance rates with anti-psychotic medication can be low.
      Even when positive symptoms are successfully treated, emotional distress can remain e.g.
      depression, anxiety and trauma. Relapse occurs in up to two thirds of patients within two
      years of the first episode. The treatment of subsequent episodes has been shown to be
      progressively less efficacious. Research has shown that fear of recurrence patients can
      experience following psychosis is predictive of relapse. Randomised clinical trials have
      found that Cognitive Behaviour Therapy (CBTp) is efficacious for treating residual
      distressing positive and negative symptoms. However, the evidence for treating emotional
      dysfunction (e.g. social anxiety, post-psychotic depression) is less clear. Acceptance and
      Commitment Therapy (ACT) incorporates acceptance and mindfulness elements into a CBT
      framework. Rather than altering the content or frequency of cognitions, ACT seeks to alter
      the individual's psychological relationship with thoughts, feelings and sensations to promote
      psychological flexibility. This research will be a pilot randomised control trial of ACT for
      treating distress following psychosis. This pilot study will establish (a) whether a larger
      scale multi-centre randomised controlled trial is warranted, (b) the acceptability of
      Acceptance and Commitment Therapy (c) the expected primary and secondary outcomes for such a
      trial and (d) the sample size required to detect such outcomes. It is hypothesised that ACT
      plus treatment as usual will be associated with a greater reduction in levels of distress
      than treatment as usual only.
    

Intervention name(s): Acceptance and Commitment Therapy
Intervention type(s): Other
Intervention description(s): Up to 10 sessions of a psychological therapy called Acceptance and Commitment Therapy
Other intervention name(s): ACT
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Psychosis; Distress; Mindfulness; Acceptance; Values