Effects of Online Acceptance and Commitment Therapy for Family Members of Individuals With Early Psychosis on Self-Stigma, Coping Strategies and Resilience: A Randomized Controlled Trial

Abstract

Introduction: Early psychosis represents a critical period that may profoundly affect not only individuals but also their family members, often leading to increased psychological distress, stigma and caregiving burden. Aim: This study aimed to evaluate the effects of online Acceptance and Commitment Therapy (ACT) on self-stigma, stress coping strategies and resilience levels among family members of individuals with early psychosis. Methods: This study was designed as an exploratory randomized controlled trial. The study population consisted of 41 caregivers of individuals diagnosed with schizophrenia and other psychotic disorders according to DSM-5 criteria, who had received their diagnosis within the past three years and applied to a psychiatry outpatient clinic at a training and research hospital between August and October 2024. Eligible participants were randomly allocated to the intervention group (n = 20) or the control group (n = 21). The intervention group participated in an eight-session online group-based Acceptance and Commitment Therapy program, while the control group did not receive any structured intervention. Data were collected using the Self-Stigma Inventory for Family Members, the Stress Coping Strategies Inventory and the Brief Resilience Scale. Evaluations were conducted at pre-test, post-test and three-month follow-up. Results: No significant differences were observed between groups at baseline (p > 0.05). Post-intervention and follow-up assessments showed significantly lower self-stigma scores in the intervention group compared to controls (p < 0.05). Additionally, coping strategies and resilience scores were significantly higher in the intervention group at post-test and follow-up (p < 0.05). Conclusion: The findings suggest that online ACT may be effective in reducing self-stigma and improving coping strategies and resilience among family members of individuals with early psychosis.