Acceptability, Feasibility, and Efficacy Potential of a Multimodal Acceptance and Commitment Therapy Intervention to Address Psychosocial and Advance Care Planning Needs among Anxious and Depressed Adults with Metastatic Cancer

Arch, Joanna J.; Fishbein, Joel N.; Ferris, Michelle; Mitchell, Jill; Levin, Michael E.; Slivjak, Elizabeth; Andorsky, David; Kutner, Jean S.

doi:10.1089/jpm.2019.0398

Cited by 28 publications

(48 citation statements)

References 38 publications

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“…Many advanced cancer patients have symptoms that interfere with functioning 1–3 . Our results in combination with prior research 10–13 provide a strong rationale for large‐scale trials of ACT to reduce symptom interference in advanced cancer and promote feasible engagement in activities that enrich quality of life. If found to be efficacious, ACT could be widely disseminated to clinicians caring for advanced cancer patients, addressing a critical gap in the evidence‐based care of this population.…”

Section: Discussionmentioning

confidence: 55%

“…Based on the current findings and promising pilot trials in advanced cancer, 10–13 mindfulness and acceptance may be targeted in interventions to reduce symptom interference with functioning. Mindfulness may be increased through meditation or purposeful attention during activities.…”

Section: Discussionmentioning

confidence: 93%

“…ACT has produced promising results in pilot trials with advanced cancer patients 10–13 . In a pilot randomized controlled trial (RCT) with late‐stage ovarian cancer patients, ACT had large effects on anxiety and depressive symptoms and global quality of life compared to cognitive‐behavioral therapy 11 .…”

Section: Introductionmentioning

confidence: 99%

“…Although ACT has been tested in a few pilots with advanced cancer patients, 10–13 establishing relationships between ACT constructs and symptoms would bolster the theoretical foundation for large‐scale trials. To date, one study of metastatic breast cancer patients linked higher symptom burden to disengagement from valued activities and psychological inflexibility, 14 and another study found that mindfulness facets were negatively correlated with physical and psychological symptoms in this population 15 .…”

Section: Introductionmentioning

confidence: 99%

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Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs

et al. 2021

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Objective This study examined relations between acceptance and commitment therapy (ACT) constructs and symptom‐based subgroups of advanced cancer patients. Methods Patients with advanced breast, gastrointestinal, lung, and prostate cancer (N = 201) completed questionnaires assessing five common symptoms and ACT variables (i.e., psychological inflexibility, cognitive fusion, values obstruction and progress, peaceful acceptance, mindfulness, and activity engagement) on one occasion. Results Latent profile analysis showed three patient classes: (1) normal levels of all symptoms (32%); (2) normal levels of all symptoms except for mild sleep problems and moderate fatigue (19%); and (3) normal pain, mild levels of sleep problems, anxiety, and depressive symptoms, and moderate fatigue (48%). Controlling for demographic covariates, lower psychological inflexibility, cognitive fusion, and values obstruction were associated with a higher likelihood of being in classes 1 or 2 than class 3. In addition, greater values progress, peaceful acceptance, mindfulness, and activity engagement were associated with a higher likelihood of being in class 1 than class 3. Of these four factors, only greater mindfulness and activity engagement were associated with a higher likelihood of being in class 2 than class 3. Conclusions Advanced cancer patients show heterogeneous symptom profiles, and even mild to moderate symptom levels are related to greater withdrawal from personally meaningful activities and less acceptance of cancer and internal experiences (e.g., symptoms, thoughts, feelings). Findings are consistent with the ACT model and support further testing of ACT to address symptom interference with functioning in advanced cancer patients.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs

et al. 2021

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“…ACT has a growing evidence-base in cancer [ 11 ], with acceptability indicated in those with advanced disease [ 12 ]. In one trial comparing ACT and cognitive behavioural therapy in patients with advanced ovarian cancer, ACT was associated with improved quality of life and reduced distress [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer

et al. 2021

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Objectives Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress. Methods Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%. Results At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials. Conclusions This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting. This study was pre-registered on the Open Science Framework (Ref: 46,033) and retrospectively registered on the ISRCTN registry (Ref: ISRCTN12084782).

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Effects of Web‐Based Acceptance and Commitment Therapy on Health‐Related Outcomes Among Patients With Lung Cancer: A Feasibility Randomized Controlled Trial

Zhang,

Liu,

Chen

et al. 2024

Psycho-Oncology

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ObjectiveTo identify the feasibility, acceptability, and effectiveness of web‐based acceptance and commitment therapy (ACT) on health‐related outcomes in patients with lung cancer.MethodsA feasibility, prospective, parallel, individual‐based, assessor‐blinded randomized controlled trial was designed. This study was conducted at a third‐level hospital in Sichuan Province, China. A total of 101 participants were enrolled and randomly assigned to usual care group or 7‐weekly web‐based acceptance and commitment therapy group. The primary outcome was feasibility and acceptability of the intervention, and the secondary outcomes including quality of life, psychological flexibility, anxiety, depression, fatigue, and sleep disturbance. Generalized estimating equations were used to evaluate the group differences. All analyses followed the principle of intention‐to‐treat.ResultsWeb‐based ACT presented good feasibility and acceptability in this study, with an attrition rate of 13.86%, a median compliance rate of 71.43%, and a satisfaction rate of 65.9%. Compared with control group, participants in intervention group reported statistically significant increases in quality of life (MD = 15.10, 95% CI: [10.09, 20.11], d = 0.37), psychological flexibility (MD = −8.42, 95% CI: [−10.81, −6.03], d = −1.47), anxiety (MD = −1.27, 95% CI: [−2.50, −0.05], d = −0.44), depression (MD = −2.11, 95% CI: [−3.28, −0.95], d = −0.76), and sleep disturbance (MD = −1.85, 95% CI: [−3.10, −0.59], d = 0.13) at postintervention, however, the improvement in fatigue was not statistically significant (MD = −2.02, 95% CI: [−9.02, 4.98], d = −0.12).ConclusionsWeb‐based ACT was an approach with good feasibility and acceptability, and it could effectively improve quality of life, psychological flexibility, anxiety, depression, and sleep disturbance in patients with lung cancer. In order to achieve better results, there is a need to design a more tailored intervention plan and a more operational platform.

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Acceptability, Feasibility, and Efficacy Potential of a Multimodal Acceptance and Commitment Therapy Intervention to Address Psychosocial and Advance Care Planning Needs among Anxious and Depressed Adults with Metastatic Cancer

Cited by 28 publications

References 38 publications

Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs

Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs

Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer

Effects of Web‐Based Acceptance and Commitment Therapy on Health‐Related Outcomes Among Patients With Lung Cancer: A Feasibility Randomized Controlled Trial

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