A randomised controlled trial of acceptance and commitment therapy (ACT) for psychosis: study protocol

BMC Psychiatry

Study Protocol

Frances Shawyer¹  David J Castle²  Steven C Hayes³  David Copolov⁴  Neil Thomas⁵  John Farhall⁶ 

[1] Department of Psychiatry, Monash University, 3800, Clayton, Victoria, Australia;School of Psychological Science, La Trobe University, 3086, Melbourne, Victoria, Australia;Department of Psychiatry, University of Melbourne, 3052, Parkville, Victoria, Australia;St Vincent’s Hospital Mental Health, 3065, Fitzroy, Victoria, Australia;Department of Psychology, University of Nevada, 89557, Reno, Nevada, USA;Office of the Vice-Chancellor and Discipline of Psychiatry, Monash University, 3800, Clayton, Victoria, Australia;Department of Psychiatry, University of Melbourne, 3010, Parkville, Victoria, Australia;Florey Institute of Neuroscience and Mental Health, 3052, Parkville, Victoria, Australia;School of Health Sciences, Swinburne University, 3122, Hawthorn, Victoria, Australia;Monash Alfred Psychiatry Research Centre, 3004, Melbourne, Victoria, Australia;School of Psychological Science, La Trobe University, 3086, Melbourne, Victoria, Australia;NorthWestern Mental Health, Royal Melbourne Hospital, 3050, Melbourne, Victoria, Australia;

关键词: Randomised controlled trial (RCT);    Psychosis;    Schizophrenia;    Auditory hallucinations;    Delusions;    Positive symptoms;    Negative symptoms;    Acceptance and commitment therapy (ACT);    Psychological therapy;    Befriending;   

DOI  :  10.1186/1471-244X-14-198

 received in 2014-06-04, accepted in 2014-07-07,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCognitive behavior therapy for psychosis has been a prominent intervention in the psychological treatment of psychosis. It is, however, a challenging therapy to deliver and, in the context of increasingly rigorous trials, recent reviews have tempered initial enthusiasm about its effectiveness in improving clinical outcomes. Acceptance and commitment therapy shows promise as a briefer, more easily implemented therapy but has not yet been rigorously evaluated in the context of psychosis. The purpose of this trial is to evaluate whether Acceptance and Commitment Therapy could reduce the distress and disability associated with psychotic symptoms in a sample of community-residing patients with chronic medication-resistant symptoms.Methods/DesignThis is a single (rater)-blind multi-centre randomised controlled trial comparing Acceptance and Commitment Therapy with an active comparison condition, Befriending. Eligible participants have current residual hallucinations or delusions with associated distress or disability which have been present continuously over the past six months despite therapeutic doses of antipsychotic medication. Following baseline assessment, participants are randomly allocated to treatment condition with blinded, post-treatment assessments conducted at the end of treatment and at 6 months follow-up. The primary outcome is overall mental state as measured using the Positive and Negative Syndrome Scale. Secondary outcomes include preoccupation, conviction, distress and disruption to life associated with symptoms as measured by the Psychotic Symptom Rating Scales, as well as social functioning and service utilisation. The main analyses will be by intention-to-treat using mixed-model repeated measures with non-parametric methods employed if required. The model of change underpinning ACT will be tested using mediation analyses.DiscussionThis protocol describes the first randomised controlled trial of Acceptance and commitment therapy in chronic medication-resistant psychosis with an active comparison condition. The rigor of the design will provide an important test of its action and efficacy in this population.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12608000210370. Date registered: 18 April 2008

【 授权许可】

Unknown   
© Thomas et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.