My Danish colleague, Jens Einar Jansen, has published a paper with me, where we argue that Acceptance and Commitment Therapy (ACT) shows promise in helping people recovering from a first episode of psychosis who have trauma symptoms (using a case series):
Jansen, J.E., & Morris, E.M.J. 2016. Acceptance and Commitment Therapy for Posttraumatic Stress Disorder in Early Psychosis: A Case Series. Cognitive and Behavioral Practice. doi:10.1016/j.cbpra.2016.04.003
Persons with psychosis often report high levels of posttraumatic stress disorder (PTSD) symptoms, which render them more vulnerable to relapse, symptom exacerbation, and reduced well-being. However, less is known about how to adequately accommodate the needs of persons recovering from a first episode of psychosis, presenting with PTSD. Further, the existing evidence-based interventions for PTSD seem less equipped to deal with serious mental illness and comorbid conditions. This study aimed to assess the efficacy, acceptability, and safety of Acceptance and Commitment Therapy (ACT) for persons suffering from PTSD with comorbid trauma and psychosis. Three consecutively referred participants meeting ICD-10 criteria for PTSD and a first-episode nonaffective psychotic disorder were treated in an outpatient service within a case-series analysis. A manual-guided ACT intervention of 12 sessions showed clinically relevant improvement on self-report measures of PTSD symptoms and emotional distress. These initial findings are promising and appear to justify a more controlled evaluation of this brief intervention.
A pre-pub version of the paper is available here.
In the paper we outline the challenges in providing psychological therapies to people recovering from early psychosis when they have trauma symptoms. We share how the transdiagnostic ACT model may provide ways to work safely and effectively with these clients, including the use of exposure informed by a psychological flexibility approach. We describe how using metaphors, perspective taking and mindfulness may support committed action for clients that is recovery-focused. This is demonstrated through a case series of three clients who engaged in ACT in an early psychosis service. These uncontrolled observations are promising: further investigation with greater methodological rigour is warranted.