Acceptance and Commitment Therapy for Psychosis - with audio

This workshop was led by Eric Morris, Gordon Mitchell, and Amy McArthur. It was held on July 17, 2008 at the BABCP National Conference, Edinburgh UK.

Workshop Description:

Acceptance and Commitment Therapy (ACT) is a contextual CBT that uses mindfulness and values-based behavioural activation strategies to help people develop a workable relationship with internal experiences as part of a direction of increasing life meaning and vitality. ACT involves an experiential approach to therapy, based upon empirical principles of behaviour change. Clients are guided through exercises and metaphors to develop a present moment focus, clarify personal values and explore the functional utility of coping strategies. There has been promising evidence to suggest ACT can help people who are distressed and/or disabled by psychosis to learn a mindful and accepting stance toward unusual experiences, reducing the impact of symptoms, and improving social functioning (Bach & Hayes 2002; Gaudiano & Herbert, 2006). This workshop will present an ACT approach to psychosis, including how the problems of psychosis are conceptualised in this model and modifications to mindfulness and acceptance techniques for this population.

Key Learning Objectives:
This workshop is designed for clinicians who work with people experiencing psychosis. The workshop is designed to:
· provide the rationale for the use of mindfulness and values based activation strategies to help people with psychosis pursue lives that are vital and personally meaningful,
· demonstrate how to conceptualise the problems of psychosis using ACT formulation,
· provide demonstrations and descriptions of the various experiential methods of ACT that are used in individual and group formats with this population

Presenters

Eric Morris works as a consultant clinical psychologist for the Lambeth Early Onset Service, an inner-city early intervention service for psychosis based in south London. He is currently conducting research in acceptance and mindfulness interventions for psychosis at the Institute of Psychiatry, King’s College London.

Gordon Mitchell and Amy McArthur are clinical psychologists in NHS Fife, Scotland, working with clients who experience severe and enduring mental illness. Over the past four years they have been increasingly using ACT approaches with this client group, particularly in-group formats.

Key References:
Bach, P. (2004). ACT with the seriously mentally ill. In S.C. Hayes & K.D. Strosahl (Eds). A practical guide to acceptance and commitment Therapy. Springer: New York.

Bach, P., & Hayes, S.C. (2002). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1129-1139.

Gaudiano, B.A., & Herbert, J.D. (2006). Acute treatment of inpatients with psychotic symptoms using acceptance and commitment therapy: Pilot results. Behaviour Research and Therapy, 44, 415-437.

Handout and Audio Recordings

The handout for the workshop is available here. Audio recordings of the workshop are also available: First part (20MB, mp3 format) and second part (30MB, mp3 format).

ACT in the UK Symposium, BABCP National Conference 2008

This symposium was held on Saturday 19th July 2008, at the BABCP National Conference Edinburgh. It highlights some the ACT research happening in the United Kingdom; the symposium was convened by Simon Houghton (Sheffield Care Trust, UK) and chaired by Joe Curran (also from Sheffield Care Trust, UK)

(Unfortunately Frank Bond was unable to present at the symposium as scheduled; similarly so for Tom Ricketts, although Giselle Brook presented in his place.)

The powerpoint presentations as well as audio are available for each presenter.

Group ACT for OCD: Development of the approach and initial findings

Tom Ricketts, Sheffield Care Trust, UK. Presenter: Giselle Brook

Abstract:

A significant proportion of clients with OCD are known not to respond to traditional exposure and response prevention (ERP) with alternative treatments such as cognitive therapy pr medication seeming to offer little additional benefit. A group treatment based on ACT was developed and delivered to a number of clients that had failed to respond to ERP. This presentation will describe the group process and report the initial clinical outcomes of this approach.

Measuring psychological flexibility and mindfulness skills with people who hear distressing voices

Eric Morris, Emmanuelle Peters & Philippa Garety, Institute of Psychiatry, King’s College London & South London & Maudsley NHS Foundation Trust, UK

Abstract:

This study involved validating the Acceptance and Action Questionnaire-II (AAQ-II) with a sample of people who hear distressing and disabling voices. The relationships of psychological flexibility and mindfulness skills with general distress, social functioning, topography of voices, symptom distress, beliefs about voices, and thought control strategies are explored.

Living successfully with pain: The role of illness representations, catastrophising and acceptance in chronic pain functioning

Sujata Bose & Tammy Spencer, NHS Tayside, UK; David Gillanders, University of Edinburgh, UK (presenter)

Abstract:

Background: Psychological factors are known to influence adjustment to chronic pain. Beliefs or appraisals relating to pain, as well as catastrophising responses to pain have both been found to influence adjustment. Recent research has shown the importance of acceptance in living successfully with pain. Acceptance is a behavioural construct defined as willingness to experience pain whilst continuing to engage in important activities. The present study examined how appraisals relating to chronic pain interact with the processes of catastrophising and acceptance to influence physical and emotional functioning.

Method: 153 individuals attending NHS pain clinics and pain support groups completed validated questionnaires measuring appraisals of chronic pain, catastrophising, acceptance and emotional and physical function. Path analyses were conducted to investigate direct and moderated relationships between pain related appraisals, catastrophising, acceptance and emotional and physical functioning.

Results: A range of direct and moderated relationships are described, with important differences between the psychological variables associated with emotional dysfunction and physical dysfunction. Whist some direct relationships between appraisals and both emotional and physical functioning were observed, catastrophising moderated the relationship between appraisals, acceptance and emotional functioning. By contrast, acceptance moderated the relationship between appraisals, catastrophising, and physical functioning.

Discussion: The findings suggest that different psychological processes many underlie successful emotional and physical functioning in chronic pain. Interestingly, appraisals relating to the controllability of pain do not show significant relationships with either emotional or physical functioning. The clinical and theoretical implications of the results are discussed, as are directions for further research.