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July 23, 2026Journal of Contemporary PsychotherapyOpen Access

ACT improves psychological flexibility and reduces negative symptoms versus active interventions, though evidence remains preliminary.

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Why the study?

The effectiveness of Acceptance and Commitment Therapy for psychosis compared to active treatments was unclear.

Does Acceptance and Commitment Therapy (ACT) improve outcomes compared to active interventions in patients with psychosis?

Comparison

Acceptance and Commitment Therapy vs active interventions

Design

Systematic review of randomized controlled trials

Key result

Acceptance and Commitment Therapy improved psychological flexibility and reduced negative symptoms compared to active interventions for psychosis, though evidence remains preliminary and heterogeneous.

Authors

LGLaureano González-AmadoAGAna González-MenéndezMFMarta Fernández-García

Discussion

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Overview

ACT not superior to active controls for psychosis; extends evidence on psychological flexibility targets but leaves optimal use open.

Key Points

  • The aim is to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) for individuals with psychosis by comparing its outcomes with active treatments.
  • Analyzed randomized controlled trials (RCTs) comparing ACT with active interventions.
  • Conducted searches in PsycINFO, Scopus, and Web of Science until February 2025.
  • Included studies that reported on social functioning, quality of life, rehospitalization rates, and symptoms.
  • ACT led to consistent improvements in psychological flexibility.
  • Some studies reported reductions in rehospitalization rates.
  • Effects on social functioning and quality of life were limited and varied across studies.

Study Design

Type

Systematic Review (n=606)

Structured PICO

Does Acceptance and Commitment Therapy (ACT) improve outcomes compared to active interventions in patients with psychosis?

P
Population
606 participants across 11 randomized controlled trials comparing Acceptance and Commitment Therapy with active interventions for psychosis.
I
Intervention
Acceptance and Commitment Therapy (ACT)
C
Comparator
Active interventions
O
Outcome
Social functioning, quality of life, rehospitalization rates, psychological flexibility, psychotic symptoms, and affective symptoms

Acceptance and Commitment Therapy appears promising for psychosis, particularly for improving psychological flexibility and reducing negative symptoms, though evidence is preliminary.

Limitations

  • Evidence remains preliminary and heterogeneous
  • Effects on social functioning and quality of life were limited and heterogeneous
  • Methodological quality was moderate

Cite This Study

González-Amado et al. (2026) conducted a systematic review in psychosis (n=606). Acceptance and Commitment Therapy (ACT) vs. active interventions was evaluated on social functioning, quality of life, rehospitalization rates, psychological flexibility, psychotic symptoms, and affective symptoms. Acceptance and Commitment Therapy improved psychological flexibility and reduced negative symptoms compared to active interventions for psychosis, though evidence remains preliminary and heterogeneous.

synapsesocial.com/papers/6a61b004faa9903c5116aa6fhttps://doi.org/10.1007/s10879-026-09748-3
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