Een dagelijks-leven interventie gericht op stress en beloning bij vroege psychose

Rationale: Despite treatment with antipsychotic medication or traditional cognitive behavioural therapy (CBT), individuals at early stages of psychotic illness - those with an at-risk mental state (ARMS) or first episode psychosis (FEP) - present with poor functioning and high levels of psychopathology. Acceptance and commitment therapy (ACT) is aimed at changing the relationship between the individual and their complaints through detachment and acceptance. Clinical improvement is achieved as a result of reduced distress and impairment, rather than the other way around. As such, ACT could be a particularly interesting candidate treatment for this vulnerable group. A promising new intervention method includes integration of the treatment in the daily-lives of individuals using mobile technology, which could substantially increase the treatment effects.



Objective: The current project aims to investigate the efficacy of a new form of treatment that integrates ACT in daily-life (ACT-DL) of individuals at early stages of psychotic illness using a smartphone app (PsyMate®). We hypothesise that the individuals who receive the experimental treatment improve on measures of distress related to psychotic experiences, global and social functioning, psychotic experiences, and psychopahtology compared to individuals who receive a control treatment.



Study design: A multi-centre randomised controlled trial with two arms i) ACT-DL inaddition to treatment as usual (TAU) and ii) TAU only, with measurements at pre-intervention, post-intervention, and follow-up at six and 12 months post-intervention.



Study population: ARMS and FEP individuals who seek help at a clinic or institution for (sub-)clinical psychotic experiences.



Intervention: Participants in the ACT-DL group will receive one psychoeducation session followed by seven standard ACT sessions, embedded in an eight-week period during which they are trained to apply the skills learned during the sessions to their daily lives with help of the PsyMate® smartphone app. Both groups will receive TAU from the clinic or institution they are admitted to.



Main study parameters/endpoints: The study’s main parameters are distress related to psychotic experiences, global and social functioning, psychotic experiences, and psychopathology as measured using questionnaires and interviews.

We hypothesise that ARMS and FEP individuals who receive the ACT-DL treatment will improve on measures of distress related to psychotic experiences, global and social functioning, psychotic experiences, and psychopahtology compared to individuals who receive TAU only.

pre-intervention measurement: T0

intervention measurements: T1.1-T1.8 (during eight-week intervention)

post-intervention measurement: T2

follow-up measurements: T3 (6 months), and T4 (12 months)

Participants in the ACT-DL group will receive seven standard group ACT sessions and a psychoeducation session, embedded in an eight-week period during which they are trained to apply the skills learned during the sessions to their daily lives with help of a PsyMate® smartphone app. Both groups will receive TAU from the clinic or institution they are admitted to.