Acceptance and Commitment Therapy-based Lifestyle Counselling Program for people with early psychosis on physical activity: A pilot randomized controlled trial

Yuen Yu Chong; Wai Tong Chien; Huanyu Mou; Chi Kin Ip; Daniel Bressington

doi:10.1016/j.schres.2024.11.007

Acceptance and Commitment Therapy-based Lifestyle Counselling Program for people with early psychosis on physical activity: A pilot randomized controlled trial

Schizophr Res. 2024 Nov 28:275:1-13. doi: 10.1016/j.schres.2024.11.007. Online ahead of print.

Authors

Yuen Yu Chong¹, Wai Tong Chien², Huanyu Mou², Chi Kin Ip³, Daniel Bressington⁴

Affiliations

¹ The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong. Electronic address: conniechong@cuhk.edu.hk.
² The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
³ New Territories East Cluster, Hospital Authority, Hong Kong.
⁴ College of Nursing & Midwifery, Charles Darwin University, Darwin, Australia.

PMID: 39612765
DOI: 10.1016/j.schres.2024.11.007

Abstract

Objective: To evaluate the feasibility, acceptability and efficacy of an Acceptance and Commitment Therapy-based Lifestyle Counselling Program (ACT-LCP) on health outcomes of individuals with early psychosis.

Methods: In this assessor-blinded, parallel-group pilot randomized controlled trial, 72 early psychosis patients (mean age [SD] = 30.51 [8.02], 58.3 % female) were randomized to either the ACT-LCP group or a control group. The ACT-LCP group underwent a five-week group program focusing on ACT-based motivation for healthy lifestyles, a booster session, and two follow-up calls. The control group received standard care, one lifestyle education session, and three follow-up calls. Outcomes including physical activity, autonomous motivation, psychological flexibility, mental status, and quality of life were measured at baseline, 1-week, and 12-week post-intervention. Recruitment, retention, and adherence rates were evaluated. Focus group interviews explored participants' experiences.

Results: Generalized estimating equation models demonstrated that when compared to the Control group, the ACT-LCP group showed a sixfold likelihood of engaging in at least 150 min of moderate to vigorous physical activity per week (adjusted prevalence ratio = 6.28, 95 % CI [2.09-18.93], P ≤ 0.001) at 12-week post-intervention. Improvements at 12-week also included autonomous motivation (adjusted mean difference, aMD = 4.74; P < .001), psychological inflexibility (aMD = -7.69; P < .001), mental status (aMD = -6.83; P < .001), and quality of life (aMD = 0.46; P = .006). Recruitment was successful at 55.8 %, retention at 89 %, and adherence at 80.6 %. Engagement challenges were noted in focus groups.

Conclusions: The ACT-LCP is feasible and acceptable, demonstrating initial efficacy in individuals with early psychosis. Further research should refine the intervention and explore long-term impacts.

Clinicaltrial: gov Identifier: NCT04916496.

Keywords: Acceptance and Commitment Therapy; Counselling; Early psychosis; Lifestyle; Physical activity; Self-determination Theory.

Associated data

ClinicalTrials.gov/NCT04916496