Acceptance and commitment therapy for depression following psychosis: an examination of clinically significant change

Abstract

Depression following psychosis is common and can impact negatively on individuals’quality of life. Thisstudy conducted post-hoc analyses on 14 participants with psychosis from a larger randomised con-trolled trial who presented with clinically important levels of depression at baseline. Eight of the par-ticipants received Acceptance and Commitment Therapy (ACT), whilst the remaining six individualsreceived treatment as usual (TAU). The focus was on investigatingclinically significantchange in outcomemeasures between baseline and 3-months post-baseline in the participants. Participants completedmeasures assessing depression and anxiety (HADS), psychosis symptoms (PANSS) and psychologicalinflexibility (AAQ-II) between baseline and at 3-month post-baseline assessments. Odds ratio analysisindicated that participants receiving ACT, compared to TAU, were 15 times more likely to achieve clini-cally significant decreases in depression scores (Fisher's Exact Test,p¼0.05). Differences between theACT and TAU groups in clinically significant changes in anxiety, psychological inflexibility, positivesymptoms, negative symptoms and general level of psychopathology were not statistically significant.The study provides tentative support for the use of ACT to treat depression emerging in the context ofpsychosis.