Mohabbat-Bahar, S., Maleki-Rizi, F., Akbari, M.E., & Moradi-Joo, M. (2015). Effectiveness of group training based on acceptance and commitment therapy on anxiety and depression of women with breast cancer. Iranian Journal of Cancer Prevention, 8, 71–76.

To evaluate the effects of group therapy on anxiety and depression

Acceptance and commitment therapy (ACT) is described as a type of “third wave” of cognitive behavioral therapy that focuses on values and goals clarification and acceptance-based behavioral strategies and mindfulness processes. Participants were randomly assigned to experimental and control groups. The experimental group had ACT held in eight sessions of 90 minutes during four consecutive weeks. These were provided in a group setting. Study measures were obtained at baseline and after the intervention.

• N= 30
• MEAN AGE = 47.2 years (range = 29-59)
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: All had breast cancer, but stages varied.  Standard therapy was completed.

• SITE: Single site  
• SETTING TYPE: Not specified  
• LOCATION: Iran

• PHASE OF CARE: Transition phase after active treatment

Randomized, controlled trial

• Beck Depression Inventory
• Beck Anxiety Scale

Anxiety and depression scores declined in the experimental group, while increasing in the control group. These differences, however, were not statistically significant (p = 0.000).

Findings suggest that a psychoeducational intervention based on acceptance and commitment therapy can be of benefit in reducing anxiety and depression among women with breast cancer.

• Small sample (less than 100)
• Baseline sample/group differences of import
• Risk of bias (no blinding)
• Risk of bias (no appropriate attentional control condition)
• Other limitations/explanation: There is no description of the control condition, and apparently no attentional control. Baseline anxiety and depression scores were higher in the experimental group, and other studies have shown that interventions can have a greater effect for those with higher anxiety and depression initially.

This type of psychoeducational intervention may be of benefit to reduce anxiety and depression in women with breast cancer. It is not clear to what extent results here were an effect of the protocol used or the participation in group sessions, which could have been supportive.  Psychoeducational interventions are generally low-risk and relatively low-cost approaches that may be of benefit to patients.