%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 8
%N 
%P e57109
%T Engagement and Acceptability of Acceptance and Commitment Therapy in Daily Life in Early Psychosis: Secondary Findings From a Multicenter Randomized Controlled Trial
%A van Aubel,Evelyne
%A Vaessen,Thomas
%A Uyttebroek,Lotte
%A Steinhart,Henrietta
%A Beijer-Klippel,Annelie
%A Batink,Tim
%A van Winkel,Ruud
%A de Haan,Lieuwe
%A van der Gaag,Mark
%A van Amelsvoort,Thérèse
%A Marcelis,Machteld
%A Schirmbeck,Frederike
%A Reininghaus,Ulrich
%A Myin-Germeys,Inez
%+ Center for Contextual Psychiatry, Psychiatry Research Group, Department of Neurosciences, KU Leuven, Herestraat 49, ON5B bus 1029, Leuven, 3000, Belgium, 32 16 37 31 74, lotte.uyttebroek@kuleuven.be
%K acceptance and commitment therapy
%K ACT
%K first episode of psychosis
%K FEP
%K ultrahigh risk for psychosis
%K UHR
%K ecological momentary intervention
%K EMI
%K mobile health
%K mHealth
%K blended care
%K mobile phone
%D 2024
%7 21.11.2024
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Acceptance 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. Objective: This 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. Methods: In 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. Results: Participants 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. Conclusions: Our results corroborate good treatment engagement with and acceptability of ACT-DL in early psychosis. We provide recommendations for future intervention optimization. Trial Registration: OMON NL46439.068.13; https://onderzoekmetmensen.nl/en/trial/24803 
%M 39570655
%R 10.2196/57109
%U https://formative.jmir.org/2024/1/e57109
%U https://doi.org/10.2196/57109
%U http://www.ncbi.nlm.nih.gov/pubmed/39570655