Arch, J.J., & Mitchell, J.L. (2016). An Acceptance and Commitment Therapy (ACT) group intervention for cancer survivors experiencing anxiety at re-entry. Psycho-Oncology, 25, 610–615.

To test the hypothesis that an Acceptance and Commitment Therapy (ACT) group intervention would reduce anxiety and increase positive outcomes among cancer survivors at the re-entry phase

Groups were facilitated by a trained clinical psychologist and oncology social worker and provided in seven weekly two-hour sessions. Participants were assisted in cultivating awareness and acceptance of thoughts and emotions about cancer, disentangling from rigid thoughts and beliefs, clarifying personal values, and committing to pursue activities aligned with those values through experiential exercises, metaphors, discussion, and homework. Study outcomes were measured at 3.5, 2, and 0.5 weeks baseline prior to the intervention, midintervention, one week following the last session, and three months after the last session.

• N = 42   
• MEAN AGE = 53.52 years
• AGE RANGE = 20–70 years
• MALES: 7.1%, FEMALES: 92.9%
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: Varied cancers; 59.5% had breast cancer. All had completed initial treatment within the past 12 months.
• OTHER KEY SAMPLE CHARACTERISTICS: Ninety-seven percent were Caucasian with an average of a bachelor’s degree and a median income of $41,000–$60,000. All patients demonstrated anxiety on screening tools, and 52% had both anxiety and depression upon study entry.

• SITE: Multi-site   
• SETTING TYPE: Other    
• LOCATION: A community center in Colorado

PHASE OF CARE: Transition phase after active treatment

Quasiexperimental

• State-Trait Anxiety Inventory (STAI)  
• Center for Epidemiological Studies Depression Scale (CESD)
• Short Form 36 Health Survey (SF-36)
• Concerns about recurrence scale
• Revised Impact of Event Scale (IES)
• Orientation to Life Questionnaire
• Participant rating of the value of each session

Anxiety declined following the intervention at immediate postmeasurement (p < 0.001) and three-month follow-up (p < 0.001). Depression symptoms also declined after the intervention (p < 0.001) and at three-month follow-up (p < 0.001). Fear of cancer recurrence decreased (p < 0.05) and at follow-up (p = 0.001).

The findings suggest that the group ACT intervention can help reduce anxiety and depression at healthcare re-entry among cancer survivors.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Measurement validity/reliability questionable
• Intervention expensive, impractical, or training needs
• Used a large battery of tests repeatedly over a short period of time—testing effect could be a threat to validity.

The group psychotherapy approach used here may be helpful to patients who are suffering from anxiety and/or depression after completion of initial treatment for cancer. Further research is needed.