Enhancing the Therapy Relationship in Acceptance and Commitment Therapy for Psychotic Symptoms

The article demonstrates how acceptance and commitment therapy (ACT) may effectively alter the function of positive psychotic symptoms and how functional analytic psychotherapy (FAP) may provide a complimentary framework for interpersonal change. ACT differs with many psychosis approaches in that it does not attempt to reduce psychotic symptoms; instead, it aims to increase psychological flexibility (e.g., acceptance) in the presence of psychotic symptoms while actively pursuing valued living. The study involves, John, a 21-year-old college student, who presented with depressive symptoms, delusional and brief visual hallucinatory episodes, and severe social isolation. ACT interventions emphasize acceptance of, and mindful reactions to, psychotic symptoms while pursuing valued life goals. As John's main goal of treatment was to develop more intimate interpersonal relationships, FAP techniques were introduced as behaviors that seemed to be distancing him from peers manifested themselves in session. The benefits and challenges of integrating ACT and FAP are discussed.