Researching the Effectiveness of Acceptance-Based Coping During Hospitalization (REACH)

Butler Hospital

Status: Completed

Conditions: Schizophrenia; Psychosis

Treatments: Behavioral: Acceptance and Commitment Therapy (ACT); Behavioral: Enhanced Treatment as Usual (eTAU)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02336581

5R34MH097987-02 (U.S. NIH Grant/Contract)

1411-001

Details and patient eligibility

About

To test the effectiveness of Acceptance and Commitment Therapy (ACT) versus enhanced Treatment as Usual (eTAU) delivered by hospital staff for inpatients with psychotic-spectrum disorders.

Full description

Patients with psychotic disorders frequently require treatment at inpatient hospital settings during periods of acute illness for crisis management and stabilization. Although these patients often receive efficacious pharmacotherapy, there is a recognized lack of empirically-supported psychosocial interventions provided to patients in typical hospital settings. The provision of high quality psychosocial treatment during hospitalization is challenging due to short lengths of stay and a general lack of trained therapist employed on hospital units who can provide these evidence-based therapies. This unmet need for hospital psychosocial treatment represents a crucial missed opportunity to teach patients coping strategies that can speed time to recovery and impact post-discharge risk factors. Acceptance and Commitment Therapy (ACT) is a newer cognitive-behavioral approach that combines innovative mindfulness-based strategies for helping patients to cope more successfully with psychotic and other symptoms and implement values-consistent behavioral goals. However, adaptations to the original ACT approach are urgently needed to foster widespread implementation in community settings. The aim of the current study is to adapt the only promising acute-care psychosocial treatment for psychosis to be implementable in an inpatient setting and pilot test its effectiveness.

Enrollment: 62 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. current psychiatric hospitalization
2. diagnosis of schizophrenia, schizoaffective disorder, schizophreniform, brief psychotic disorder, delusional disorder, specified/unspecified other psychotic disorder, or a diagnosis of a mood disorder (major depressive disorder or bipolar disorder) with psychotic features, as determined by chart review and confirmed by the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-5
3. 18 years or older
4. ability to speak and read English.

Exclusion criteria

1. psychosis severe enough to prevent participation in regular hospital groups
2. psychotic disorder related to a general medical condition or substance-induced psychotic disorder
3. significant cognitive impairment (mini-mental state exam score < 15).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

62 participants in 2 patient groups

Acceptance and Commitment Therapy (ACT)

Experimental group

Description:

ACT which includes individual and group sessions during hospitalization and follow-up phone contacts the first month following hospital discharge.

Treatment:

Behavioral: Acceptance and Commitment Therapy (ACT)

Enhanced Treatment as Usual (eTAU)

Active Comparator group

Description:

Enhanced treatment as usual (eTAU) which includes other individual and group sessions during hospitalization and follow-up phone contacts the first month following hospital discharge.

Treatment:

Behavioral: Enhanced Treatment as Usual (eTAU)