The evidence base of Acceptance and Commitment Therapy (ACT) in psychosis: A systematic review

This review explores the evidence base for Acceptance and Commitment Therapy (ACT) for people experiencing psychosis, the quality of the evidence, and potential benefits of this intervention. A systematic search of the literature was conducted on the electronic academic databases MEDLINE, Google Scholar, PsycArticles and PsycINFO up to October 2016. A systematic search identified 427 articles and thirteen studies were selected as eligible for review. The current research base indicates that ACT has the potential to be considered an effective treatment in psychosis even in briefer forms, such as 4 sessions for inpatients, and in individuals experiencing severe symptoms or complex co-morbidities. There is emerging evidence that ACT is a useful intervention for individuals that may present with psychosis whether at inpatient settings or in community teams. ACT can be utilised in group settings as this indicates time and cost-effectiveness (reaching a larger range of individuals). The studies suggest ACT can help reduce rehospitalisation rates, have an impact on the psychological inflexibility of people experiencing psychosis and is beneficial for people with either first episode or enduring psychosis. Nevertheless, there is a need to take the current findings with caution due to methodological criticism and potential for bias within some studies, which is discussed in the review. Despite this, advances to our understanding of ACT for those experiencing psychosis is improving. To continue this, larger randomised controlled trials are required to give this research area a more robust evidence base. Studies should also aim to include follow up data to assess the impact of the brief interventions on a much longer scale. Other recommendations for future research studies are noted.

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