Effectiveness of Acceptance and Commitment Therapy on Psychotic Severity Among Inpatients With Primary Psychoses: A Randomized Controlled Trial

ABSTRACT This study investigated the effectiveness of acceptance and commitment therapy (ACT) compared to treatment as usual in managing psychotic symptoms, emotional dysregulation, recovery and psychological flexibility in inpatients with primary psychoses. The Primary outcome assessed the positive and negative syndrome scale, while the secondary outcomes were to assess difficulties in the emotion regulation scale, recovery assessment scale and acceptance and action questionnaire. An open‐label, two‐arm parallel randomized controlled trial was conducted. Participants diagnosed with primary psychoses were randomly assigned to either the ACT ( n = 33) or treatment‐as‐usual ( n = 32) group. The intervention included six structured sessions of ACT. ACT significantly reduced psychotic symptoms from 128 to 104 ( Z = 5.01) compared to treatment as usual from 130 to 117 ( Z = 4.88). Emotional regulation improved significantly in the ACT group from 73 to 55 ( Z = 4.835) compared to treatment as usual from 73 to 70 ( Z = 2.406). Recovery increased in the ACT group from 50 to 88 ( Z = 5.01) compared to treatment as usual from 51 to 61 ( Z = 4.93). Psychological flexibility improved in the ACT group from 33 to 25 ( Z = 4.98) compared to treatment as usual from 33 to 31 ( Z = 4.75). Between‐group differences after intervention were significant for psychotic symptoms, emotional regulation, recovery and psychological flexibility ( Z = 2.356, 4.652, 3.881 and 4.453, respectively). Accordingly, the current study demonstrates the effectiveness of ACT in reducing psychotic symptoms and improving emotional regulation, recovery and psychological flexibility in patients with primary psychoses. Integrating ACT into standard care protocols can enhance treatment outcomes, offering a comprehensive approach to managing complex mental health conditions. Trial Registration: ClinicalTrials.gov identifier: NCT06160869