Group Acceptance and Commitment Therapy for Recovery From Psychosis: Protocol for a Single-Group Waitlist Trial

Marilyn L Cugnetto; Eric M J Morris; Siobain F Bonfield; Jesse Gates; Ilona Morrison; Ellie R Newman; Julia D Nicholls; Lisa M Soares; Megan T Antonucci; Jacinta R Clemente; Claire L M Garratt; Eliot Goldstone; David A Pavone; John Farhall

doi:10.2196/49849

Group Acceptance and Commitment Therapy for Recovery From Psychosis: Protocol for a Single-Group Waitlist Trial

JMIR Res Protoc. 2024 Mar 18:13:e49849. doi: 10.2196/49849.

Authors

Marilyn L Cugnetto^{1

2}, Eric M J Morris^{1

2}, Siobain F Bonfield³, Jesse Gates^{2

4}, Ilona Morrison⁵, Ellie R Newman^{2

3

6}, Julia D Nicholls^{2

6}, Lisa M Soares⁷, Megan T Antonucci⁵, Jacinta R Clemente¹, Claire L M Garratt⁶, Eliot Goldstone⁷, David A Pavone¹, John Farhall^{2

7}

Affiliations

¹ Mental Health Division, Northern Health, Epping, Victoria, Australia.
² Department of Psychology, Counselling & Therapy, School of Psychology & Public Health, La Trobe University, Bundoora, Victoria, Australia.
³ Peninsula Health Mental Health Service, Frankston, Victoria, Australia.
⁴ Orygen, Parkville, Victoria, Australia.
⁵ St Vincent's Hospital, Melbourne, Victoria, Australia.
⁶ Alfred Mental and Addiction Health, Melbourne, Victoria, Australia.
⁷ NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

PMID: 38498035
PMCID: PMC10985603
DOI: 10.2196/49849

Abstract

Background: Psychological interventions, along with antipsychotic medications, are recommended for adults diagnosed with a psychotic disorder. While initially designed to mitigate positive symptoms, psychological interventions targeting personal recovery were developed and aligned with the recovery framework that many mental health services have adopted. Acceptance and Commitment Therapy (ACT) for psychosis is one such intervention that shows promise when delivered in an individual format. There is preliminary evidence that ACT for psychosis in a group format improves recovery.

Objective: This trial aims to evaluate the effectiveness of the "Recovery ACT" group program on personal recovery among adults living with a psychotic disorder.

Methods: Our unfunded study is a multiagency, prospective, nonrandomized, waitlist control, single-group trial of the Recovery ACT group program. The program involves 7 weekly group sessions of 90 minutes duration and a 90-minute booster session held 1 month later. We intend to recruit 160 adults living with a psychotic disorder who enroll in a group that is offered as a routine clinical service at participating public mental health services in Melbourne, Victoria, Australia. The 4 assessment time points are 4-6 weeks before the start of the group program, at the start of the group program, at the end of the group program, and at the booster session. There is an optional midgroup assessment and follow-up study. The primary outcome is personal recovery. Secondary outcomes include participants' well-being and psychological flexibility processes. Qualitative data are also collected from participants and facilitators.

Results: Recruitment began in September 2019 and is ongoing until 2024, subsequent to a 24-month disruption due to the COVID-19 pandemic. As of the submission of this paper, 93 participants consented to the evaluation, 65 completed T1 measures, and 40 had a complete data set for the proposed analyses.

Conclusions: This is the first trial evaluating the effectiveness of the Recovery ACT group program on personal recovery for adults living with a psychotic disorder. Findings will contribute to knowledge about psychosocial interventions for adults living with psychosis. This trial may also serve as an example of a partnership between clinicians and academics that can facilitate the translation of research into practice.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12620000223932; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000223932.

International registered report identifier (irrid): DERR1-10.2196/49849.

Keywords: ACT; Acceptance and Commitment Therapy; group therapy; interventions; personal recovery; protocol; psychosis; psychotic disorders; public mental health services.

©Marilyn L Cugnetto, Eric M J Morris, Siobain F Bonfield, Jesse Gates, Ilona Morrison, Ellie R Newman, Julia D Nicholls, Lisa M Soares, Megan T Antonucci, Jacinta R Clemente, Claire L M Garratt, Eliot Goldstone, David A Pavone, John Farhall. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 18.03.2024.