Using Acceptance and Commitment Therapy With People With Psychosis: A Case Study

There is a small but increasing body of research to suggest that acceptance and commitment therapy (ACT) is useful for people experiencing psychosis. As an intervention, ACT does not specifically target symptom reduction but rather emphasizes more flexible responding in the presence of psychotic symptoms to encourage increases in value-driven behavior. A case study is presented, detailing use of ACT in working with someone experiencing long-standing distressing psychosis, specifically, paranoia, delusions, and associated emotional disturbance. Measures of general distress, severity, and intensity of delusional thoughts and depression were taken at two points prior to therapy starting and again post intervention. All measures showed improvements post therapy, although symptoms did not remit completely. However, the client reported significant increases in value-based activities. The results indicated that, although not a primary treatment target, ACT can help in reduction of symptoms. As expected, the intervention can also assist in increasing value-based behavior, in spite of the presence of ongoing psychotic symptoms.