ACT May Help Reduce Relapse in Psychosis

While both ACT and treatment as usual reduced psychotic symptoms, only ACT reduced rehospitalization and psychological distress.


When acceptance and commitment therapy (ACT) was added to treatment, people with psychosis experienced less distress and were less likely to be re-hospitalized, according to a new study in Schizophrenia Research.

After four months, both ACT and ‘treatment as usual’ reduced psychotic symptoms. However, those who did not receive ACT were 3.76 times more likely to be re-hospitalized. Only those who received ACT improved over time on a measure of overall psychological distress.

“ACT-IN is feasible and acceptable for patients with psychosis, can be implemented by hospital staff when integrated into acute treatment, and may result in decreased rehospitalization compared to alternative therapies,” the researchers write.

Brandon A. Gaudiano led the research at the Alpert Medical School of Brown University.

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  1. “The first outcome was measured with the Brief Psychiatric Rating Scale. The researchers found that both groups improved in terms of psychiatric symptoms, with no significant difference between groups.”

    Therapy therapy therapy will cure you cure you cure you. I am a bit jaundiced about the therapy panacea for schizophrenia. I have had psychology sessions, therapy sessions, music therapy, art therapy, cbt therapy, and many more. Therapy could blame me for my not being cured. Or blame me for not taking the consecrated wafer of trauma acceptance. It is all rather hoccus poccus. Magic spells lifted or applied.

    Mostly I think NOTHING cures schizophrenia. It is like terminal cancer. Having time with a therapist or just a person who understands this is enough to calm the anguished threadbare breastbone.

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  2. I sort of agree that any improvement in addressing “psychosis” non-pharmacologically and without violence might be positive.

    That last paragraph goes there.

    The review apparently focuses on relapse.

    I am no expert, but could ACT increase compliance with pharmacological treatment and that could explain why the relapse rate was less, less than half in the ACT group vs the non-ACT (I think 39% vs 17%)?.

    Apparently all patients were hospitalized and given “routine” treatment, lies, fabrications, medications, imaginary diagnoses, etc. Except for ACT in hospital and afterwards.

    And as the lingo goes relapses are very influenced by non-compliance, it does not sound unreasonable to me that ACT could increase compliance instead of improvement on whatever it’s promoters claim it does.

    For instance, what’s the cumulative dose difference between groups. Admitting it might be misleading, non-compliants might actually have higher doses!.

    Still waiting for the RADAR authors and commenters to explain to me at least clearly how that went in that study: cummulative doses…

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  3. It’s good knowing there’s (a few) people in the psych business who are looking at a different approach. However, it draws attention the fact that treating people with respect isn’t high on their agenda — if it’s on their agenda at all.

    Who could have guessed that treating people respectfully (acceptance, non-judgmentally) would help them “improve”, and — above and beyond this — that no one need be an “expert” to do so!!!

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