Acceptance and Commitment Therapy for depression following psychosis: An examination of clinically significant change

Depression following psychosis is common and can impact negatively on individuals’ quality of life. This study conducted post-hoc analyses on 14 participants with psychosis from a larger randomised controlled trial who presented with clinically important levels of depression at baseline. Eight of the participants received Acceptance and Commitment Therapy (ACT), whilst the remaining six individuals received treatment as usual (TAU). The focus was on investigating clinically significant change in outcome measures between baseline and 3-months post-baseline in the participants. Participants completed measures assessing depression and anxiety (HADS), psychosis symptoms (PANSS) and psychological inflexibility (AAQ-II) between baseline and at 3-month post-baseline assessments. Odds ratio analysis indicated that participants receiving ACT, compared to TAU, were 15 times more likely to achieve clinically significant decreases in depression scores (Fisher's Exact Test, p=0.05). Differences between the ACT and TAU groups in clinically significant changes in anxiety, psychological inflexibility, positive symptoms, 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 of psychosis.