Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Aug;19(8):e70073.
doi: 10.1111/eip.70073.

Perspectives of Patients With Early Psychosis on the Use of an App in Acceptance and Commitment Therapy: A Qualitative Study

Jara Bouws  1   2 , Lotte Uyttebroek  3 , Joanne R Beames  3 , Mariken de Koning  1   2 , Frederike Schirmbeck  4 , An Henrard  5 , Ulrich Reininghaus  4 , Lieuwe de Haan  1   2 , Inez Myin-Germeys  3
Affiliations
Randomized Controlled Trial

Perspectives of Patients With Early Psychosis on the Use of an App in Acceptance and Commitment Therapy: A Qualitative Study

Jara Bouws et al. Early Interv Psychiatry. 2025 Aug.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: acceptance and commitment therapy; ecological momentary assessment; first episode psychosis; mental health; qualitative study; smartphone app.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Example of EMA question, EMI ACT mindfulness exercise, and EMI ACT‐metaphor.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Ali, M. P. , Tiles‐Sar N., Simons C. J. P., et al. 2024. “Does Stigma Leave Its Mark? The Interplay Between Negative Effects of Perceived Stigma With Positive Effect of Self‐Esteem on Long‐Term Social Functioning in Schizophrenia.” Schizophrenia Research 274: 417–426. 10.1016/j.schres.2024.10.011. - DOI - PubMed
    1. Alvarez‐Jimenez, M. , Gleeson J. F., Bendall S., et al. 2018. “Enhancing Social Functioning in Young People at Ultra High Risk (UHR) for Psychosis: A Pilot Study of a Novel Strengths and Mindfulness‐Based Online Social Therapy.” Schizophrenia Research 202: 369–377. 10.1016/j.schres.2018.07.022. - DOI - PubMed
    1. A‐Tjak, J. G. L. , Davis M. L., Morina N., Powers M. B., Smits J. A. J., and Emmelkamp P. M. G.. 2015. “A Meta‐Analysis of the Efficacy of Acceptance and Commitment Therapy for Clinically Relevant Mental and Physical Health Problems.” Psychotherapy and Psychosomatics 84, no. 1: 30–36. 10.1159/000365764. - DOI - PubMed
    1. Bell, I. H. , and Alvarez‐Jimenez M.. 2019. “Digital Technology to Enhance Clinical Care of Early Psychosis.” Current Treatment Options in Psychiatry 6, no. 3: 256–270. 10.1007/s40501-019-00182-y. - DOI
    1. Bell, I. H. , Lim M. H., Rossell S. L., and Thomas N.. 2017. “Ecological Momentary Assessment and Intervention in the Treatment of Psychotic Disorders: A Systematic Review.” Psychiatric Services 68, no. 11: 1172–1181. 10.1176/appi.ps.201600523. - DOI - PubMed

Publication types

LinkOut - more resources