The Application of Acceptance Commitment Therapy (ACT) and Family Psychoeducation (FPE) to Clients with Scizophrenia and Aggressive Behavior

Andi Buanasari; Budi Anna Keliat; Herni Susanti

doi:10.14710/nmjn.v10i1.22220

DOI: https://doi.org/10.14710/nmjn.v10i1.22220

The Application of Acceptance Commitment Therapy (ACT) and Family Psychoeducation (FPE) to Clients with Scizophrenia and Aggressive Behavior

*Andi Buanasari - Nursing Department, Faculty of Medicine, Sam Ratulangi University, Indonesia

Budi Anna Keliat

- Faculty of Nursing, Universitas Indonesia, Indonesia

Herni Susanti

- Faculty of Nursing, Universitas Indonesia, Indonesia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN22220,
    author = {Andi Buanasari and Budi Keliat and Herni Susanti},
    title = {The Application of Acceptance Commitment Therapy (ACT) and Family Psychoeducation (FPE) to Clients with Scizophrenia and Aggressive Behavior},
    journal = {Nurse Media Journal of Nursing},
  volume = {10},
    number = {1},
    year = {2020},
    keywords = {Acceptance and commitment therapy; family psychoeducation; aggressive behavior; case series; schizophrenia},
    abstract = {  Background:  Aggressive behavior frequently occurs in clients with schizophrenia and causes injuries to the clients themselves, others, and the environment. It becomes one of the most common factors causing rehospitalization in schizophrenic clients. Aggressive behavior can be managed by the intervention administered by nurses in the usual way (treatment as usual; TAU) as well as psychotherapy (acceptance and commitment therapy; ACT and family psychoeducation; FPE).   Purpose:  This study aimed to investigate the effectiveness of acceptance and commitment therapy (ACT) and family psychoeducation (FPE) on schizophrenic clients with aggressive behavior.   Methods:  This study used a case series method to report four selected cases of schizophrenic clients with aggressive behavior. Acceptance and commitment therapy (ACT), family psychoeducation (FPE), and treatment as usual (TAU) were delivered to four clients with aggressive behavior for six weeks using the Stuart Stress-Adaptation Model.   Results:  The finding showed decreased symptoms of aggressive behavior in cognitive, affective, physiological, behavioral, and social aspects and increased ability to control anger, to accept their problems, and to commit to the therapy after ACT, FPE, and TAU interventions.   Conclusion:  This report showed that TAU, ACT, and FPE effectively decreased the symptoms of aggressive behavior and increased the clients’ ability to control anger. },
   issn = {2406-8799},   pages = {11--21}  doi = {10.14710/nmjn.v10i1.22220},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/22220}
}

Citation Format:

Abstract

Background: Aggressive behavior frequently occurs in clients with schizophrenia and causes injuries to the clients themselves, others, and the environment. It becomes one of the most common factors causing rehospitalization in schizophrenic clients. Aggressive behavior can be managed by the intervention administered by nurses in the usual way (treatment as usual; TAU) as well as psychotherapy (acceptance and commitment therapy; ACT and family psychoeducation; FPE).

Purpose: This study aimed to investigate the effectiveness of acceptance and commitment therapy (ACT) and family psychoeducation (FPE) on schizophrenic clients with aggressive behavior.

Methods: This study used a case series method to report four selected cases of schizophrenic clients with aggressive behavior. Acceptance and commitment therapy (ACT), family psychoeducation (FPE), and treatment as usual (TAU) were delivered to four clients with aggressive behavior for six weeks using the Stuart Stress-Adaptation Model.

Results: The finding showed decreased symptoms of aggressive behavior in cognitive, affective, physiological, behavioral, and social aspects and increased ability to control anger, to accept their problems, and to commit to the therapy after ACT, FPE, and TAU interventions.

Conclusion: This report showed that TAU, ACT, and FPE effectively decreased the symptoms of aggressive behavior and increased the clients’ ability to control anger.

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Keywords: Acceptance and commitment therapy; family psychoeducation; aggressive behavior; case series; schizophrenia

Funding: Sam Ratulangi Universit; Universitas Indonesia; Marzoeki Mahdi Mental Hospital

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Section: Articles

Language : EN

In Vol 10, No 1 (2020): (April 2020)

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Bach, P., Hasyes, S. C., & Gallop, R. (2012). Long-term effects of brief acceptance and commitment therapy for psychosis. Behaviour Modification, 36(2), 165-581. doi: 10.1177/0145445511427193
Bogojevic, G., Ziravac, L., & Zigmund, D. (2015). Impact of expressed emotion on the course of schizophrenia. European Psychiatry, 30(1), 390. doi: 10.1016/S0924-9338(15)30309-6
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Bucci, S., Birchwood, M., Twist, L., Tarrier, N., Emsley, R., & Haddock, G. (2013). Predicting compliance with command hallucinations: anger, impulsivity and appraisals of voices' power and intent. Schizophrenia Research, 147(1), 163-168. doi: 10.1016/j.schres.2013.02.037
Butler, L., Johns, L. C., Byrne, M., Joseph, C., O’Donoghue, E., Jolley, S., … & Oliver, J. E. (2016). Running acceptance and commitment therapy groups for psychosis in community settings. Journal of Contextual Behavioral Science, 5(1), 33-38. doi: 10.1016/j.jcbs.2015.12.001
Caqueo-Urízar, A., Rus-Calafell, M., Urzúa, A., Escudero, J., & Gutiérrez-Maldonado, J. (2015). The role of family therapy in the management of schizophrenia: challenges and solutions. Neuropsychiatric disease and treatment, 11, 145–151. doi: 10.2147/NDT.S51331
Fleischman, A., Werbeloff, N., Yoffe, R., Davidson, M., & Weiser, M. (2014). Schizophrenia and violent crime: a population-based study. Psychological Medicine, 44(14), 3051-3057. doi: 10.1017/S0033291714000695
Gearing, R. E. (2008). Evidence-based family psychoeducational interventions for children and adolescents with psychotic disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 17(1), 2-11
Ghouchani, S., Molavi, N., Massah, O., Sadeghi, M., Mousavi, S. H., Noroozi, M., … Farhoudian, A. (2018). Effectiveness of Acceptance and Commitment Therapy (ACT) on aggression of patients with psychosis due to methamphetamine use: A pilot study. Journal of Substance Use, 23(4), 402-407. doi: 10.1080/14659891.2018.1436602
Goulet, M., & Larue, C. (2016). Post-seclusion and/or restraint review in psychiatry: A scoping review. Archives of Psychiatric Nursing, 30(1), 120-128. doi: 10.1016/j.apnu.2015.09.001
Green, A. I., Noordsy, D. L., Brunette, M. F., & O’Keefe, C. (2008). Substance abuse and schizophrenia: Pharmacotherapeutic intervention. Journal of Substance Abuse Treamentt, 34(1). 61-67. doi: 10.1016/j.jsat.2007.01.008
Haddock, G., Eisner, E., Davies, G., Coupe, N., & Barrowclough, C. (2013). Psychotic symptoms, self-harm and violence in individuals with schizophrenia and substance misuse problem. Schizophrenia Research, 151(1-3), 215-220, doi: 10.1016/j.schres.2013.10.031
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behaviour Therapy, 35(4), 639-665. doi: 10.1016/S0005-7894(04)80013-3
Hayward, M., Strauss, C., & McCarthy-Jones, S. (2014). Psychological Approaches to Understanding and Treating Auditory Hallucinations: From Theory to Therapy (Explorations in Mental Health). New York: Taylor and Francis Group
Jansen, J. E., & Morris, E. M. J. (2017). Acceptance and commitment therapy for posttraumatic stress disorder in early psychosis: A case series. Cognitive and Behavioral Practice, 24(2), 187-199. doi: 10.1016/j.cbpra.2016.04.003
Keliat, B. A., Azwar, A., Bachtiar, A., & Hamid, A. Y. S. (2009). Influence of the abilities in controlling violence behaviour to the length of stay of schizophrenic clients in Bogor mental hospital, Indonesia. Medical Journal Indonesia, 18(1), 31-35. doi: 10.13181/mji.v18i1.336
Knezevic, V., Mitrovic, D., Drezgic-Vukic, S., Knezevic, J., Ivezic, A., Siladji-Mladenovic, D., & Golubovic, B. (2016). Prevalence and correlates of aggression and hostility in hospitalized schizophrenic patients. Journal of Interpersonal Violence, 32(2), 151-163. doi: 10.1177/0886260515585537
Lasebikan, V., & Ayinde, O. (2013). Family burden in caregivers of schizophrenia patients: Prevalence and socio-demographic correlates. Indian Journal of Psychological Medicine, 35(1), 60-66. doi: 10.4103/0253-7176.112205
Nirmala, B. P., Vranda, M. N., & Reddy, S. (2011). Indian Journal of Psychological Medicine, 33(2), 119-122. doi: 10.4103/0253-7176.92052
Rafiyah, I. (2011). Review: Burden on Family Caregivers Caring for Patients with Schizophrenia and Its Related Factors. Nurse Media Journal of Nursing, 1(1), 29-41. doi: 10.14710/nmjn.v1i1.745
Ran, M. S., Chan, C. L., Ng, S. M., Guo, L. T., & Xiang, M. Z. (2015). The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychological Medicine, 45(10), 2197-2204. doi: 10.1017/S0033291715000197
Richmond, J. S., Berlin, J. S., Fishkind, A. B., Holloman, G. H., Zeller, S. L, Wilson, M. P., … & Ng, A. T. (2012). Verbal de-escalation of the agitated patient: Consensus statement of the American Association for Emergency Psychiatry project BETA de-escalation workgroup. Western Journal of Emergency Medicine, 13(1),17–25. doi: 10.5811/westjem.2011.9.6864
Rueve, M. E., & Welton, R. S. (2008). Violence and mental illness. Psychiatry (Edgmont), 5(5), 34–48
Setiawan, H. (2017). Penerapan terapi kognitif perilaku dan terapi asertif terhadap klien risiko perilaku kekerasan di ruang akut rumah sakit jiwa [Application of CBT and Assertive training to clients with risks of aggressive behaviors in acute psychiatric care] (Unpublished thesis). Universitas Indonesia, Depok, Indonesia
Sharif, F., Shaygan, M., & Mani, A. (2012). Effect of a psycho-educational intervention for family members on caregiver burdens and psychiatric symptoms in patients with schizophrenia in Shiraz, Iran. BMC Psychiatry, 12(48), 1-9. doi: 10.1186/1471-244X-12-48
Shawyer, F., Farhall, J., Thomas, N., Hayes, S. C., Gallop, R., Copolov, D., & Castle, D. J. (2016). Acceptance and commitment therapy for psychosis: randomised controlled trial. The British Journal of Psychiatry, 210(2), 140-148. doi: 10.1192/bjp.bp.116.182865
Shawyer, F., Mackinnon, A., Farhall, J., Taruer, T., & Copolov, D. (2003). Command hallucinations and violence: Implications for detention and treatment. Psychiatry, Psychology and Law, 10(1), 97-107. doi: 10.1375/pplt.2003.10.1.97
Stanley, B., Molcho, A., Stanley, M., Winchel, R., Gameroff, M. J., Parsons, B., & Mann. J. J. (2000). Association of aggressive behavior with altered serotonergic function in patients who are not suicidal. American Journal of Psychiatry, 157(4), 609-614. doi: 10.1176/appi.ajp.157.4.609
Stanley, S., Balakrishnan, & Ilangovan, S. (2016). Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. Journal of Mental Health, 26(2), 134-141. doi: 10.1080/09638237.2016.1276537
Stuart, G. W. (2013). Principles and Practice of Psychiatric Nursing. Missouri: Elsevier Mosby
Sulistiowati, N. M. D., Keliat, B. A., & Wardani, I. Y. (2014). Pengaruh acceptance and commitment therapy terhadap gejala dan kemampuan klien dengan resiko perilaku kekerasan [The effect of Acceptance Commitment Therapy on symptoms and Ability on Clients with aggressive behaviour]. Jurnal Keperawatan Jiwa, 2(1), 51-57
Susanti, H., Lovell, K., & Mairs, H. (2018). What does the literature suggest about what carers need from mental health services for their own wellbeing? A Systematic Review. Enfermeria Clinica, 28(1), 102-111. doi: 10.1016/S1130-8621(18)30047-0
Susanti, H., Lovell, K., & Mairs, H. (2019). Emotional reactions and coping strategies of carers of people with serious mental illnesses: A focus group study. Enfermeria Clinica, 29(2), 275-27. doi: 10.1016/j.enfcli.2019.04.033
Torrey, E. F. (2011). Stigma and Violence: Isn’t It Time to Connect the Dots?. Schizophrenia Bulletin, 37(5), 892-896. doi: 10.1093/schbul/sbr057
Volavka, J. (2014). Aggression in psychoses. Advances in Psychiatry, 1-20. doi: 10.1155/2014/196281
Volavka, J., & Citrome, L. (2011). Pathways to aggression in schizophrenia affect results of treatment. Schizophrenia Bulletin, 37(5), 921-929. doi: 10.1093/schbul/sbr04

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The Application of Acceptance Commitment Therapy (ACT) and Family Psychoeducation (FPE) to Clients with Scizophrenia and Aggressive Behavior

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