Published online Aug 19, 2025. doi: 10.5498/wjp.v15.i8.107313
Revised: April 26, 2025
Accepted: June 12, 2025
Published online: August 19, 2025
Processing time: 141 Days and 13.2 Hours
Acceptance and commitment therapy (ACT) is a third-generation therapy that appears to be a promising psychological intervention for psychotic disorders. While several systematic reviews and meta-analyses that address the efficacy of ACT for psychosis have been conducted, no systematic review has specifically focused on the application of ACT to the early stages of psychosis.
To review the state of the art regarding the feasibility and efficacy of treating early psychosis (EP) with ACT-based interventions.
First, we describe the foundations of the ACT model to provide the background required to contextualize the main objective of this review. Second, we searched the PubMed and PsycINFO databases for studies published up to January 2025 and identified eight studies that met our selection criteria. The systematic review was conducted in accordance with the PRISMA guidelines and the critical app
All studies were published after 2019. Among the reviewed studies, five were RCTs with a total combined sample of 399 nonoverlapping participants. The methodological quality was moderate for RCTs. The results showed that ACT-based treatments are feasible and improve psychotic symptoms, medication adherence, and global functioning in patients with EP. Furthermore, preliminary evidence exists for the benefits of group-based and online-delivered programs and those that combine face-to-face therapy with novel real-time digital inter
ACT-based treatments in the early stages of psychosis are feasible and improve symptoms, treatment adherence, and self-care skills. Although promising, these results are inconclusive. Further research is required.
Core Tip: Acceptance and commitment therapy (ACT) is a promising intervention for the treatment of psychotic disorders, but research on its application to the early stages of the disease is still limited. This study reviews the current understanding of ACT-based interventions for the early phases of psychosis. ACT applied to early psychosis is feasible and improves psychotic symptoms, treatment adherence, and functioning. Furthermore, preliminary evidence indicates the benefits of group-based, online-delivered, and hybrid interventions that combine face-to-face treatment with innovative real-time digital interventions. Although promising, further research should confirm these preliminary findings.