In plain language
When a parent is diagnosed with cancer, the disruption ripples through every part of a teenager's or young adult's life: family roles shift, communication becomes strained, time for study and friends shrinks, and support needs often go unmet. Truce is a seven-week Acceptance and Commitment Therapy (ACT) group program, delivered by the Australian cancer support organisation Canteen, designed specifically for young people aged 14–22 who have a parent receiving treatment for cancer or diagnosed within the last five years.
In this pragmatic controlled trial, 55 young people who completed the Truce program were compared with 46 wait-list controls on unmet needs and psychological distress. The researchers also examined whether process variables—mindfulness, cognitive inflexibility, family functioning, and cancer-related life events—influenced who benefited and why.
Unmet needs improved over time for everyone (effect size 0.42), but improvements were significantly greater for those who attended Truce (effect size 0.29)—that is, the program helped over and above the natural adjustment people make to a difficult situation. Distress did not show a significant program benefit. Within the intervention group, the young people who improved most were those who started out more distressed and less mindful, suggesting the program reaches those who need it most. Notably, in the control group, experiencing negative cancer-related life events undermined improvement, whereas program participants seemed buffered against this effect. The specific mechanisms of change, however, remain unclear, as no significant mediators were identified.
Key findings
- Participants' unmet needs improved significantly over time (p = 0.036, effect size = 0.42), and improvements were greater for the Truce intervention group than wait-list controls (p = 0.040, effect size = 0.29).
- There was no evidence of a significant program benefit for psychological distress.
- Within the intervention group, greater improvements in unmet needs were associated with higher baseline distress (p = 0.022) and lower baseline mindfulness (p = 0.044)—the program helped most those who started off worse.
- No significant mediators of change were identified among the process variables tested (mindfulness, cognitive inflexibility, family functioning), so the mechanisms of change remain unclear.
- For the control group only, experiencing negative or mixed cancer-related life events significantly moderated (reduced) improvement (p = 0.024), suggesting Truce buffers the impact of negative cancer-related events on well-being.
- The trial involved young people aged 14–22 with a parent or caregiver receiving cancer treatment or diagnosed in the last five years (intervention n = 55; control n = 46).
How to cite
APA
Bibby, K., McDonald, F. E. J., Ciarrochi, J., Allison, K. R., Hulbert-Williams, N. J., Konings, S., Wright, A., Tracey, D., & Patterson, P. (2024). Truce: Outcomes and mechanisms of change of a seven-week acceptance and commitment therapy program for young people whose parent has cancer. Journal of Contextual Behavioral Science, 33, 100813. https://doi.org/10.1016/j.jcbs.2024.100813
BibTeX
@article{bibby2024truce,
author = {Bibby, Kit and McDonald, Fiona E. J. and Ciarrochi, Joseph and Allison, Kimberley R. and Hulbert-Williams, Nicholas J. and Konings, Stephanie and Wright, Adam and Tracey, Danielle and Patterson, Pandora},
title = {Truce: Outcomes and mechanisms of change of a seven-week acceptance and commitment therapy program for young people whose parent has cancer},
journal = {Journal of Contextual Behavioral Science},
year = {2024},
volume = {33},
pages = {100813},
doi = {10.1016/j.jcbs.2024.100813}
}
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.