Treatment adherence in patients with schizophrenia after acceptance and commitment therapy

Pages: 1067-1073
Minkesh Chowdhary and Masroor Jahan (Department of Clinical Psychology, Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Kankee, Ranchi, Jharkhand)

Since times immemorial, science has made significant progress in understanding the nature, causes and treatment of schizophrenia but still we are lagging behind and this condition continues to cause significant disability among the individuals with this condition. Apart from psychopathology in terms of various positive and negative symptoms, a large number of these patients tend to experience throughout their life significant disability in different walks of life, they have to face external and internal stigma of mental illness, they are prone to have poor quality of life, poor self-esteem, poor well-being and frequent re-hospitalizations. One potential reason for all these problems in patients with schizophrenia is non-adherence to prescribed medications which in turn leads to worsening of psychopathology with other issues. To deal with this issue of non-adherence several psychological approaches were introduced out of which acceptance and commitment therapy is relatively new entry. In the present study efforts were made to establish its applicability in improving medication adherence among patients with schizophrenia. The present study was conducted with the aim of investigating the applicability of acceptance and commitment therapy in patients with schizophrenia in improving their medication adherence. A Pre-test and post test with control group design was used in this study. Equal number of patients was randomly assigned to acceptance and commitment therapy group (TAU + ACT) and treatment as usual group (TAU). Patients in the TAU+ACT condition received approximately 8-10 one hour long sessions of individual ACT twice in a week during their stay in the hospital while patients in treatment as usual group (TAU) received standard treatment. To monitor their progress they were assessed with Medication adherence rating scale and with other measures on pre-intervention phase, post intervention phase and at follow up phase. As a result of ACT application, significant improvement was noticed in terms of medication adherence related behaviours. The overall results of this study show that application of acceptance and commitment therapy in patients with schizophrenia brought significant positive changes in medication adherence. The gains that were attained at post intervention phase were maintained at follow up, hence, it can be said that acceptance and commitment therapy was efficacious and effective in bringing up positive changes in different outcome variables in patients with schizophrenia. Effects of this intervention were found durable which suggest that this intervention has potentials that can be utilized to improve the condition of patients with schizophrenia or with other psychotic disorders.