Possibilities for the Acceptance and Commitment Therapy in the Clinic of the First Psychotic Episode

Background: helping young people after a first psychotic episode (FPE) requires a comprehensive approach that focuses not only on the reduction of psychopathological symptoms but also on restoring social and occupational functioning as much as possible. Acceptance and commitment therapy (ACT) is a modern cognitive behavioral psychotherapeutic approach that allows working with psychotic patients in an age-appropriate manner, which makes it promising for use in the russian population.

Methods: using the keyword combinations “acceptance and commitment therapy”, “psychosis”, “meta-analysis”, “delusions”, “hallucinations”, etc., we searched the scientific literature in Google Scholar and PubMed databases for meta-analytic, review and other papers evaluating the effectiveness of ACT in working with psychotic patients.

Results: five meta-analyses and review papers were selected that provided the evidence sought. According to them, despite some contradictory and few data, the primary evidence assessment indicates a possible benefit of ACT in combination with psychopharmacotherapy in psychosis compared with conventional medication. There is evidence of reduced hospitalization and relapse rates with ACT, reduction of affective symptomatology and distress associated with experiencing psychotic symptoms, and there is some evidence of help in reducing the impact of productive psychotic symptoms on patient functioning. Negative symptomatology, in turn, has to date been less well researched in this regard. According to studies, the effectiveness of ACT as a form of psychotherapy begins to be noted after 3–4 sessions.

Conclusion: further research is needed to test this approach on a Russian-speaking sample, and foreign works on the assessment of effectiveness show the prospects for its introduction into clinical practice.

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