Evidence map›Paper›PMID 39570655›Full record

Trial reportJMIR formative research2024

Engagement and Acceptability of Acceptance and Commitment Therapy in Daily Life in Early Psychosis: Secondary Findings From a Multicenter Randomized Controlled Trial.

Evelyne van Aubel, Thomas Vaessen, Lotte Uyttebroek, Henrietta Steinhart, Annelie Beijer-Klippel, Tim Batink, Ruud van Winkel, Lieuwe de Haan, Mark van der Gaag, Thérèse van Amelsvoort and 4 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in JMIR formative research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Evelyne van AubelCenter for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0002-8846-4701
Thomas VaessenCenter for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0002-9300-3117
Lotte UyttebroekCenter for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0002-6510-3196
Henrietta SteinhartCenter for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0002-4966-1964
Annelie Beijer-KlippelCenter for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0001-5527-5368
Tim BatinkDepartment of Lifespan Psychology, Faculty of Psychology, Open University, Heerlen, Netherlands.ORCID 0000-0003-1965-6248
Ruud van WinkelCenter for Clinical Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0001-6262-1935
Lieuwe de HaanDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.ORCID 0000-0002-3820-7926
Mark van der GaagDepartment of Clinical Psychology, VU Amsterdam, Amsterdam, Netherlands.ORCID 0000-0002-3525-6415
Thérèse van AmelsvoortDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.ORCID 0000-0003-1135-5133
Machteld MarcelisDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.ORCID 0000-0003-0045-9244
Frederike SchirmbeckDepartment of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.ORCID 0000-0003-1700-0958
Ulrich ReininghausDepartment of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.ORCID 0000-0002-9227-5436
Inez Myin-GermeysCenter for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Leuven, Belgium.ORCID 0000-0002-3731-4930

Funding

EPA EP-C-13-022
6 · The paper itself

Abstract

backgroundAcceptance and commitment therapy (ACT) is promising in the treatment of early psychosis. Augmenting face-to-face ACT with mobile health ecological momentary interventions may increase its treatment effects and empower clients to take treatment into their own hands.

objectiveThis study aimed to investigate and predict treatment engagement with and acceptability of acceptance and commitment therapy in daily life (ACT-DL), a novel ecological momentary intervention for people with an ultrahigh risk state and a first episode of psychosis.

methodsIn the multicenter randomized controlled trial, 148 individuals with ultrahigh risk or first-episode psychosis aged 15-65 years were randomized to treatment as usual only (control) or to ACT-DL combined with treatment as usual (experimental), consisting of 8 face-to-face sessions augmented with an ACT-based smartphone app, delivering ACT skills and techniques in daily life. For individuals in the intervention arm, we collected data on treatment engagement with and acceptability of ACT-DL during and after the intervention. Predictors of treatment engagement and acceptability included baseline demographic, clinical, and functional outcomes.

resultsParticipants who received ACT-DL in addition to treatment as usual (n=71) completed a mean of 6 (SD 3) sessions, with 59% (n=42) of participants completing all sessions. App engagement data (n=58) shows that, on a weekly basis, participants used the app 13 times and were compliant with 6 of 24 (25%) notifications. Distribution plots of debriefing scores (n=46) show that 85%-96% of participants reported usefulness on all acceptability items to at least some extent (scores ≥2; 1=no usefulness) and that 91% (n=42) of participants reported perceived burden by number and length of notifications (scores ≥2; 1=no burden). Multiple linear regression models were fitted to predict treatment engagement and acceptability. Ethnic minority backgrounds predicted lower notification response compliance (B=-4.37; P=.01), yet higher app usefulness (B=1.25; P=.049). Negative (B=-0.26; P=.01) and affective (B=0.14; P=.04) symptom severity predicted lower and higher ACT training usefulness, respectively. Being female (B=-1.03; P=.005) predicted lower usefulness of the ACT metaphor images on the app.

conclusionsOur results corroborate good treatment engagement with and acceptability of ACT-DL in early psychosis. We provide recommendations for future intervention optimization.

trial registrationOMON NL46439.068.13; https://onderzoekmetmensen.nl/en/trial/24803.

Indexed as

Acceptance and Commitment TherapyPatient Acceptance of Health CarePsychotic DisordersAdolescentAdultAgedEcological Momentary AssessmentFemaleHumansMaleMiddle AgedYoung Adultacceptance and commitment therapyACTblended careecological momentary interventionEMIFEPfirst episode of psychosismHealthmobile healthmobile phoneUHRultrahigh risk for psychosis

Identifiers

PMID39570655
PMCPMC11621719

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.