Moitra, E. & Gaudiano, B. A. (2016). A psychological flexibility model of medication adherence in psychotic-spectrum disorders. Journal of Contextual Behavioral Science, 5, 252-257.
A new model of medication adherence, rooted in an understanding of psychological flexibility, is presented here to illustrate how Acceptance and Commitment Therapy processes might guide the development of more effective adherence interventions for patients with psychotic-spectrum disorders. Medication adherence is a product of a negotiated, collaborative agreement between patient and provider, and it is predicted by a number of internal and external contextual factors. Irrespective of the ongoing debates about the long-term necessity and utility of antipsychotic pharmacotherapies, data clearly demonstrate that suboptimal medication adherence in the acute phase of treatment for psychosis undermines their potential benefits and puts undue burden on the healthcare system. However, every patient's reasons for nonadherence are unique, those reasons can change over time, and a patient's attitudes and beliefs about medications can fluctuate and can be inconsistent across medications. Psychological flexibility provides a dynamic framework in which adherence behaviors can be interpreted through a contextual lens, allowing providers to work collaboratively with patients to improve their self-care.
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