Bouws Jara, Uyttebroek Lotte, Beames Joanne R, de Koning Mariken, Schirmbeck Frederike, Henrard An, Reininghaus Ulrich, de Haan Lieuwe, Myin-Germeys Inez
Arkin, Centre for Mental Health Care, Amsterdam, the Netherlands.
Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Early Interv Psychiatry. 2025 Aug;19(8):e70073. doi: 10.1111/eip.70073.
Individuals with early psychosis received Acceptance and Commitment Therapy in daily life (ACT-DL), consisting of 8 face-to-face sessions and use of a mobile app at home, as part of a randomised controlled trial (INTERACT). Those receiving ACT-DL showed improvement in negative symptoms and global functioning compared to the control condition. The current study qualitatively explores patients' perspectives on the ACT-DL app and perceived areas for improvement.
The ACT-DL app prompted individuals randomly multiple times a day between therapy sessions to complete questionnaires (Ecological Momentary Assessments, EMA) and ACT metaphors or exercises (Ecological Momentary Interventions, EMI). User experiences with the ACT-DL app were explored in 17 semi-structured interviews within 6 months after the intervention and analysed using template thematic analysis.
Three themes were formed: 1. App functionalities and usability; consisting mainly of perceived practical obstacles. 2. Additional value of the app; on how the EMAs raised levels of awareness for feelings, thoughts, and behaviour, and the positive evaluation of the ACT exercises in the EMI part of the app. 3. Improving applicability and effect of the ACT-DL app; with practical feedback from participants.
Individuals with early psychosis were generally positive about the effects of the ACT-DL app, attributing benefits to increased awareness via EMAs and to the ACT exercises. However, they experienced difficulties using the app during work and social activities. Participants provided valuable suggestions to improve the app's effectiveness and applicability.
作为一项随机对照试验（INTERACT）的一部分，早期精神病患者接受了日常生活中的接纳与承诺疗法（ACT-DL），该疗法包括8次面对面治疗以及在家中使用一款移动应用程序。与对照组相比，接受ACT-DL治疗的患者在阴性症状和整体功能方面有所改善。本研究定性地探讨了患者对ACT-DL应用程序的看法以及认为可改进的方面。
ACT-DL应用程序在治疗期间每天多次随机提示个体完成问卷（生态瞬时评估，EMA）以及ACT隐喻或练习（生态瞬时干预，EMI）。在干预后6个月内，通过17次半结构化访谈探讨了用户对ACT-DL应用程序的体验，并使用模板主题分析法进行分析。
形成了三个主题：1. 应用程序功能和可用性；主要包括感知到的实际障碍。2. 应用程序的附加价值；关于EMA如何提高对情感、思想和行为的认知水平，以及对应用程序EMI部分中ACT练习的积极评价。3. 提高ACT-DL应用程序的适用性和效果；有参与者提供的实际反馈。
早期精神病患者总体上对ACT-DL应用程序的效果持积极态度，将益处归因于通过EMA提高的认知以及ACT练习。然而，他们在工作和社交活动中使用该应用程序时遇到了困难。参与者提供了有价值的建议以提高应用程序的有效性和适用性。
