title: Acceptance and commitment therapy for psychosis: randomised controlled trial.
abstract: The efficacy of acceptance and commitment therapy (ACT) in psychosis has been reported but not for medication-resistant psychosis.
  
  
  
  To test the efficacy of ACT in a sample of community-residing patients with persisting psychotic symptoms. (Australian New Zealand Clinical Trials Registry: ACTRN12608000210370.) METHOD: The primary outcome was overall mental state at post-therapy (Positive and Negative Syndrome Scale - total); secondary outcomes were psychotic symptom dimensions and functioning. In total, 96 patients were randomised to ACT (n = 49) or befriending (n = 47). Symptom, functioning and process measures were administered at baseline, post-therapy and 6 months later.
  
  
  
  There was no group difference on overall mental state. In secondary analyses the ACT group showed greater improvement in positive symptoms and hallucination distress at follow-up: Cohen's d = 0.52 (95% CI 0.07-0.98) and 0.65 (95% CI 0.24-1.06), respectively.
  
  
  
  Improvements reflected the treatment focus on positive symptoms; however, absence of process-measure changes suggests that the ACT intervention used did not manipulate targeted processes beyond befriending. Symptom-specific therapy refinements, improved investigation of process and attention to cognitive functioning and dose are warranted in future research.
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.
authors.forename: Frances
authors.initials: F
authors.lastname: Shawyer
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia j.farhall@latrobe.edu.au.
authors.forename: John
authors.initials: J
authors.lastname: Farhall
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Thomas
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hayes
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Gallop
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Copolov
authors.affiliation: Frances Shawyer, PhD, MAPS, MCCLP, School of Psychology and Public Health, La Trobe University, Victoria and Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia; John Farhall, PhD, FAPS, School of Psychology and Public Health, La Trobe University, Victoria and NorthWestern Mental Health, Royal Melbourne Hospital, Victoria, Australia; Neil Thomas, DClinPsy, School of Psychology and Public Health, La Trobe University, Victoria, School of Health Sciences, Swinburne University, Hawthorn, Victoria and Monash Alfred Psychiatry Research Centre, Melbourne, Victoria, Australia; Steven C. Hayes, PhD, Department of Psychology, University of Nevada, Reno, Nevada, USA; Robert Gallop, PhD, Department of Mathematics, Applied Statistics Program, West Chester University, West Chester, Pennsylvania, USA; David Copolov, PhD, MBBS, Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, Clayton, Victoria, Department of Psychiatry, University of Melbourne, Parkville, Victoria and Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia; David J. Castle, MD, FRCPsych, FRANZCP, Department of Psychiatry, University of Melbourne, Parkville, Victoria and St Vincent's Hospital Mental Health, Fitzroy, Victoria, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Castle
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011618:Psychotic Disorders / Q000628:therapy*; D055815:Young Adult