Acceptance and Commitment Therapy for Psychotic Disorders
Summary
Acceptance and Commitment Therapy (ACT) represents a third-wave cognitive-behavioural approach tailored to address the complex experiential dimensions of psychotic disorders. Rather than aiming to eliminate psychotic symptoms, ACT seeks to reduce the distress associated with hallucinations and delusions by fostering acceptance of otherwise unwanted thoughts and feelings, and by enhancing commitment to values-based actions. Central to the approach is the cultivation of psychological flexibility, enabling individuals to remain present with internal experiences while engaging in meaningful activities. Key therapeutic processes include cognitive defusion, in which patients learn to observe thoughts without becoming entangled, and mindfulness strategies that promote a non-judgmental awareness of the present moment. Across diverse settings—ranging from early intervention services to acute inpatient units—ACT has been adapted into group formats, digital and blended-care models, and brief crisis interventions. Evidence indicates that ACT can alleviate psychotic distress, improve social and occupational functioning, and reduce rehospitalisation risk, offering a scalable complement to pharmacotherapy and standard psychological treatments.
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Acceptance and Commitment Therapy for Psychotic Disorders publication trend
The graph below shows the total number of articles in acceptance and commitment therapy for psychotic disorders across all publications each year (not limited to Nature Index journals).
Technical terms
Psychological flexibility: The capacity to remain in contact with the present moment and pursue valued actions despite challenging internal experiences.
Cognitive defusion: A process by which thoughts are perceived as transient mental events rather than literal truths, reducing their impact on behaviour.
Ecological momentary intervention: Delivery of therapeutic strategies and prompts in real time during everyday life, often via digital devices.
Early psychosis: A stage encompassing individuals at ultrahigh risk of developing psychosis or those experiencing a first episode, targeted for early intervention.
References
- Predicting clinical outcomes in a blended care intervention for early psychosis: Acceptance and Commitment Therapy in Daily-Life (ACT-DL). Translational Psychiatry (2025).
- Targeting metacognitive change mechanisms in acute inpatients with psychotic symptoms: feasibility and acceptability of a modularized group intervention. European Archives of Psychiatry and Clinical Neuroscience (2023).
- Acceptance and Commitment Therapy for Inpatients with Psychosis (the REACH Study): Protocol for Treatment Development and Pilot Testing. Healthcare (2017).
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