Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3-arm pilot randomized controlled trial

dc.contributor.authorJohns, Shelley A.
dc.contributor.authorStutz, Patrick V.
dc.contributor.authorTalib, Tasneem
dc.contributor.authorCohee, Andrea A.
dc.contributor.authorBeck-Coon, Kathleen A.
dc.contributor.authorBrown, Linda F.
dc.contributor.authorWilhelm, Laura R.
dc.contributor.authorMonaham, Patrick O.
dc.contributor.authorLaPradd, Michelle L.
dc.contributor.authorChampion, Victoria L.
dc.contributor.authorMiller, Kathy D.
dc.contributor.authorGiesler, R. Brian
dc.date.accessioned2021-10-04T21:11:57Z
dc.date.available2021-10-04T21:11:57Z
dc.date.issued2020
dc.description.abstractBackground Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence-based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group-based ACT for FCR in BCS. Methods Post-treatment BCS (91 patients with stage I-III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2-hour group sessions), survivorship education (SE; 6 weekly 2-hour group sessions), or enhanced usual care (EUC; one 30-minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post-traumatic stress, depression, QOL, and other FCR-related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent-to-treat analysis. Results Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within-group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between-group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within-group reductions across all time points. By T4, significant moderate to large between-group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR-related psychological distress. Conclusions Group-based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.en_US
dc.identifier.citationJohns, S. A., Stutz, P. V., Talib, T. L., Cohee, A. A., Beck‐Coon, K. A., Brown, L. F., ... & Giesler, R. B. (2020). Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial. Cancer, 126(1), 211-218.en_US
dc.identifier.urihttps://hdl.handle.net/1805/26690
dc.language.isoen_USen_US
dc.publisherWileyen_US
dc.relation.isversionof10.1002/cncr.32518en_US
dc.subjectAcceptance and commitment therapyen_US
dc.subjectSurvivorshipen_US
dc.subjectFearen_US
dc.subjectBreast neoplasmsen_US
dc.subjectAnxietyen_US
dc.subjectQuality of lifeen_US
dc.titleAcceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3-arm pilot randomized controlled trialen_US
dc.typeArticleen_US
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