A study protocol for Truce: a pragmatic controlled trial of a seven-week acceptance and commitment therapy program for young people who have a parent with cancer

@article{patterson2015a,
  author = {Patterson, Pandora and McDonald, Fiona E J and Ciarrochi, Joseph and Hayes, Louise and Tracey, Danielle and Wakefield, Claire E. and White, Kate},
  title = {A study protocol for Truce: a pragmatic controlled trial of a seven-week acceptance and commitment therapy program for young people who have a parent with cancer},
  year = {2015},
  journal = {BMC Psychology},
  volume = {3},
  number = {1},
  publisher = {Springer Science and Business Media LLC},
  doi = {10.1186/s40359-015-0087-y}
}

In plain language

Every year, more than 21,000 Australian adolescents and young adults face a parent’s new cancer diagnosis. Even when the prognosis is good, these young people deal with parental absences, disrupted family roles, extra caring responsibilities, and the looming threat of loss — yet there are very few evidence-based programs designed to support them. This paper lays out the rationale and full study design for evaluating Truce, a seven-week, face-to-face group program developed to fill that gap.

Truce is grounded in Acceptance and Commitment Therapy (ACT), a well-supported approach that seems particularly suited to this group: it teaches young people to accept what cannot be changed — such as the threat of cancer and the difficult feelings it brings — while still engaging in actions that reflect their values. The program is manualised, includes a participant workbook, and involves parents in one of its seven sessions. Rather than waiting for mental-health problems to appear, it takes a preventive approach for a group known to be at risk.

The trial is designed as a pragmatic controlled effectiveness study: young people aged 14 to 22 whose parent was diagnosed with cancer in the past five years are assigned to the program or to a wait-list control, with assessments before and after the program and at two-month follow-up. The researchers predict the program will reduce distress and increase psychological well-being, and they will also examine ACT processes such as experiential avoidance and mindfulness, family functioning, unmet needs, program fidelity, and satisfaction. As a protocol paper, it reports the planned methods rather than results, providing a transparent blueprint for the evaluation.

Key findings

• Truce is a manualised, seven-week, facilitated, face-to-face group program based on Acceptance and Commitment Therapy for young people aged 14–22 who have a parent diagnosed with cancer within the last five years.
• The trial uses a pragmatic 2 (intervention vs wait-list control) × 3 (pre-treatment, post-treatment, 2-month follow-up) repeated-measures design, with a target of 65 participants per condition.
• The primary hypothesis is that participants will show significant reductions in distress and increases in psychological well-being relative to wait-list controls, maintained at two-month follow-up.
• Secondary analyses will examine ACT-related processes (experiential avoidance and mindfulness), family functioning, unmet needs, demographic moderators, program fidelity, and satisfaction.
• The sixth session involves both the young person and their parent, and the program design draws on Olson’s Circumplex Model of family functioning.
• The trial is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12615000761561).

Related work

• All publications by Joseph Ciarrochi (searchable, with free PDFs)
• Process-Based Therapy & Idionomic Analysis

Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.