6. Psychological therapies                                                                      2. Acceptance: which means               Unlike CBT approaches it doesn’t 
                                                                                                      making room for painful feelings,        focus on the content of distressing 
                                                                                                      urges and sensations, and allowing       thoughts, but just on accepting 
                            Acceptance and                                                            them to come and go without a            them and not letting them get in 
                       commitment therapy                                                             struggle.                                the way of your goals
                                                                                                      3. Mindfulness: which kind of            Does it work?
                                                                                                      means being in the moment (the 
                                                                                                      ‘here-and-now’), and being open to       There are now at least four RCT 
                                                                                                      and interested in your experiences.      studies that have looked at ACT for 
                                                                                                                                               unusual distressing experiences 
                                                                                                      At the same time, ACT will help you      and psychosis. These studies have 
                                               Remember one thumbs up means                           to clarify what is truly important       shown that ACT is helpful for 
                                               that enough people have done                           and meaningful to you – i.e. your        reducing the distress that comes 
      The main focus of this treatment         research to show that this approach                    values – then use that knowledge to      with the experience of psychosis. 
      is on psychological factors.             does work.                                             guide, inspire and encourage you to 
                                                                                                      change your life for the better. 
      What is it?                              What does it aim to do?                                       ACT helped to focus on what’s 
      Acceptance and Commitment                The core skills that ACT focuses on                      important to me rather than all the other 
      Therapy (ACT, which is pronounced        include:                                                 stuff that goes on in my head. It gave 
      as the word ‘act’) is aimed at helping                                                            me that time and space to say ‘hang on 
      you to take active steps towards         1.  Defusion: which means                                a minute’ and let it go by, rather than 
      building a rich, full and meaningful     distancing yourself from, and                            getting carried away with thoughts. 
      life, and at the same time, helping      letting go of, unhelpful thoughts, 
      you to develop psychological skills      beliefs and memories.                                    It gave me a breather where I was able 
      to be able to deal with painful                                                                   to pause. This really helped me to get 
      thoughts and feelings, in better                                                                  my life back on track again. 
      ways so that they have much less                                                                  Louis, 29
      impact and influence on your life.
      92 likemind.nhs.uk                                                                              Myth-busting information about treatment choices                            93
                                                                                                    In a US-based study, ACT has also       You can check the main 
                                 ACT can make a real difference                                     been shown to help people keep          international ACT website which 
                             to people’s lives. Understandably,                                     out of hospital for longer. Although    has a list of ACT therapists in  
                             distressing psychosis has a major impact                               still early, ACT appears to be          the UK – contextualscience.org –  
                             and people often get very caught up                                    useful in helping people develop        or the register for the British 
                             in struggling with the experience. ACT                                 better psychological health and         Association of Behavioural and 
                             helps to gently and slowly introduce                                   wellbeing by using the core skills      Cognitive Psychotherapists at  
                             additional skills and ways of responding                               (the defusion, acceptance and           cbtregisteruk.com
                                                                                                    mindfulness ones we mentioned 
                             to these experiences that allows the                                   above) which help with recovery.            Main pro
                             person to manage them more effectively.                                                                        ACT can help you to think 
                             At the same time, ACT is very good at                                  Additionally, there are several 
                                                                                                    studies underway that are looking       more about actively building a 
                             helping people to reactivate their lives                               at the effectiveness of ACT in          meaningful life, and also learning 
                             by developing goals that are clearly                                   groups. Early evidence suggests         skills to help lessen the impact of 
                             linked to what is important to the                                     that ACT groups may be both             your distressing experiences.
                             individual. In this way, recovery becomes                              helpful and useful.                         Main con
                             not just about escaping distress, but                                  The National Institute for Health 
                             about rebuilding a purposeful life.                                    and Care Excellence (NICE)              ACT is not yet commonly available 
                             Dr Joe Oliver, Clinical Psychologist                                                                           in the NHS. The evidence, whilst 
                                                                                                    NICE does not yet recommend ACT         promising, is still in the early stages 
                                                                                                    for unusual upsetting experiences.      so it is not yet possible to say who 
                                                                                                                                            may benefit more from ACT 
                                                                                                    How can I get this treatment?           treatments.
                                                                                                    ACT is a newer treatment for 
                                                                                                    unusual upsetting experiences. 
                                                                                                    Although some NHS services do 
                                                                                                    offer ACT, it is not yet common 
                                                                                                    place. It is possible to get ACT from 
                                                                                                    an independent therapist, who 
                                                                                                    specialises in ACT.
      94 likemind.nhs.uk                                                                            Myth-busting information about treatment choices                           95