The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial

The present study examined the impact of a brief version of an acceptance-based treatment (acceptance and commitment therapy; ACT) that teaches patients to accept unavoidable private events; to identify and focus on actions directed toward valued goals; and to defuse from odd cognition, just noticing thoughts rather than treating them as either true or false. Eighty inpatient participants with positive psychotic symptoms were randomly assigned to treatment as usual (TAU) or to 4 sessions of ACT plus TAU. ACT participants showed significantly higher symptom reporting and lower symptom believability and a rate of rehospitalization half that of TAU participants over a 4-month follow-up period. The same basic pattern of results was seen with all participant subgroups except delusional participants who denied symptoms. Nearly 4 % of all schizophrenics who initially are medication responsive and continue to be medication compliant are rehospi-talized each month, at a cost to society approaching one billion dollars a year (Weiden & Olfson, 1995). There are many reasons for rehospitalization (Doering et al., 1998), but part of this problem may be traced to the persistence of auditory hallucinations an