DIAGNOSIS: Schizophrenia and Other Severe Mental Illnesses
TREATMENT: Acceptance and Commitment Therapy for Psychosis

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Brief Summary

Acceptance and Commitment Therapy (ACT) is a behavioral therapy that is based on Relational Frame Theory, a theory of how human language influences experience and behavior. ACT aims to change the relationship individuals have with their own thoughts, feelings, memories, and physical sensations that are feared or avoided. Acceptance and mindfulness strategies are used to teach patients to decrease avoidance, attachment to cognitions, and increase focus on the present. Patients learn to clarify their goals and values and to commit to behavioral change strategies. This treatment has been applied to a number of conditions, including psychosis.

By design ACT for psychosis does not directly target reduction of psychosis symptoms; rather, ACT aims to improve the ability to cope with psychotic symptoms and to reduce distress associated with psychotic symptoms.

Treatment Resources

Editors:Matt Southward, PhD

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

Luoma, J. B., Hayes, S. C., & Walser, R. D. (2007). Learning ACT: An acceptance and commitment therapy skills-training manual for therapists. New Harbinger Publications.

Hayes, S. C. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. New Harbinger Publications.

Hayes, S. C., & Strosahl, K. D. (2005). A practical guide to acceptance and commitment therapy. Springer Science.

Hayes. S. C., Strosahl, K. D., & Wilson, K. G. (2003). Acceptance and commitment therapy: An experiential approach to behavior change. NY: Guilford.

O’Donoghue, E. K., Morris, E. M. J., Oliver, J. E., & Johns, L. C. (2018). ACT for psychosis recovery: A practical manual for group-based interventions using acceptance and commitment therapy. Context Press/New Harbinger Publications.

Books Available for Purchase Through External Sites

Books on Acceptance & Commitment Therapy from the Association for Contextual Behavioral Science: https://contextualscience.org/books_tapes

Training Materials and Workshops

General ACT training resources from the Association for Contextual Behavioral Science: https://contextualscience.org/training

Measures, Handouts and Worksheets

ACT for Psychosis videos, worksheets, and mindfulness recordings: http://actforpsychosis.com/resources

Video Demonstrations

General ACT video exercises and demonstrations from the Association for Contextual Behavioral Science: https://contextualscience.org/free_videos_learning_about_and_applying_act

Clinical Trials

Bach, P., Hayes, S. C. & Gallop, R. (2012). Long term effects of brief acceptance and commitment therapy for psychosis. Behavior Modification, 36, 165-181. https://doi.org/10.1177/0145445511427193

White, R., Gumley, A., McTaggart, J., Rattrie, L., McConville, D., Cleare, S., & Mitchell, G. (2011). A feasibility study of acceptance and commitment therapy for emotional dysfunction following psychosis. Behaviour Research and Therapy, 49, 901-907. https://doi.org/10.1016/j.brat.2011.09.003

Gaudiano, B. A., & Herbert, J. D. (2006). Acute treatment of inpatients with psychotic symptoms using acceptance and commitment therapy. Behaviour Research and Therapy, 44, 415-437. https://doi.org/10.1016/j.brat.2005.02.007

Bach, P. & Hayes, S. C. (2002). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70(5), 1129-1139. https://doi.org/10.1037//0022-006x.70.5.1129

Meta-analyses and Systematic Reviews

Morris, E. M. J., Johns, L. C., & Gaudiano, B. A. (2023). Acceptance and commitment therapy for psychosis: Current status, lingering questions and future directions. Psychology and Psychotherapy: Theory, Research, & Practice. Advance online publication. https://doi.org/10.1111/papt.12479

Other Treatment Resources

General ACT audio exercises from the Association for Contextual Behavioral Science: https://contextualscience.org/free_audio

General readings on ACT from the Association for Contextual Behavioral Science: https://contextualscience.org/list_of_resources_for_learning_act

General ACT clinical tools from the Association for Contextual Behavioral Science: https://contextualscience.org/resources_for_clinicians