In plain language
A cancer diagnosis often brings shock, fear, sadness, and lasting distress — more than a third of patients experience significant psychological difficulties. Most psychological treatments studied in cancer care try to reduce symptoms by disputing unhelpful thoughts. This study asked a different question: can a therapy that teaches patients to accept difficult thoughts and feelings, while acting on what they truly value, improve their quality of life?
Forty-five cancer patients at the Wollongong Hospital Cancer Care Centre in Australia, all reporting elevated distress, received nine weekly individual sessions of Acceptance and Commitment Therapy (ACT). The manualized program covered defusing from distressing thoughts, mindfulness, seeing the self as separate from one's thoughts, and clarifying values with concrete action plans. Patients completed measures of distress, mood, quality of life, and psychological flexibility before, during, and after the program, and again three months later.
Patients improved significantly on all outcomes, and the gains held at three-month follow-up. Effect sizes for distress and mood were large — comparable to those reported for cognitive behaviour therapy in cancer populations. Importantly, increases in psychological flexibility (the core process ACT aims to change) predicted later improvements in quality of life, distress, and mood, supporting ACT's central premise that accepting distress, rather than fighting it, opens the way to better well-being.
Key findings
- Across the nine-session ACT intervention, the 45 cancer patients showed significant improvements in distress, mood disturbance, and quality of life from pre- to post-intervention and from pre-intervention to 3-month follow-up.
- Effect sizes were large for distress (up to 1.11) and mood disturbance (up to 1.12), and medium for quality of life (.56) — comparable to effects reported for CBT with cancer patients.
- Improvements were maintained at 3-month follow-up, with no significant decline from post-intervention.
- The proportion of participants with normal levels of depression rose from 41% before treatment to 90% at follow-up; normal anxiety rose from 38.5% to 68.2%, and normal stress from 46.2% to 86.4%.
- Psychological flexibility (AAQ-II) increased steadily across the intervention, with the largest effect size of any measure at follow-up (1.38).
- Mid-to-post gains in psychological flexibility predicted post-to-follow-up improvements in quality of life, distress, and mood, consistent with ACT's proposed mechanism of change.
How to cite
APA
Feros, D. L., Lane, L., Ciarrochi, J., & Blackledge, J. T. (2013). Acceptance and Commitment Therapy (ACT) for improving the lives of cancer patients: A preliminary study. Psycho-Oncology, 22, 459-464. https://doi.org/10.1002/pon.2083
BibTeX
@article{feros2013acceptance,
author = {Feros, Danielle L. and Lane, Lisbeth and Ciarrochi, Joseph and Blackledge, John T.},
title = {Acceptance and Commitment Therapy ({ACT}) for improving the lives of cancer patients: a preliminary study},
journal = {Psycho-Oncology},
year = {2013},
volume = {22},
pages = {459--464},
doi = {10.1002/pon.2083}
}
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.