Acceptance and commitment therapy applied to early psychosis: Therapeutic foundations and a narrative systematic review

Table 1 Essential components of the therapeutic process of acceptance and commitment therapy for psychosis

Therapeutic elements	Main goals
Create a state of creative hopelessness	The goal is for patients to pay attention to their strategies for solving their problems and how these strategies ultimately failed
Raise the possibility that “the problem is control”	The patients should now understand that certain aspects of their experience (emotions, thoughts, memories) cannot be controlled. The use of central metaphors is recommended
Create a distance from the language (defusion)	Starting to doubt aspects other than hallucinations or delusions is one way to get patients to distance themselves from their experiences
Help create a transcendent sense of self (“self as context”)	Focus intervention on enhancing “self as context.” ACT techniques focus primarily on strengthening the sense of “self as context” instead of “self as content”
To clarify and strengthen the patient’s values	Look for conditions in which a person with psychosis can pursue these values despite their circumstances (e.g., symptoms). Materialize these values in actions aimed at achieving them
Develop willpower	The will presupposes a hierarchical organization of ends and places the person in front of the troubled and, therefore, the inevitably tragic character of existence. Therapy is placed in the context of the person's life, and relapses are included as an additional aspect

ACT: Acceptance and commitment therapy.