Intervention and mediation effects of target processes in a randomized controlled trial of Acceptance and Commitment Therapy for anxious cancer survivors in community oncology clinics.

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Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 376 words

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Keywords Acceptance and commitment therapy; Anxiety; Neoplasms; Experiential avoidance; Self-compassion; Coping style Abstract Objective Acceptance and Commitment Therapy (ACT) is a promising psycho-oncological intervention, but its mechanisms in real-world settings are not fully understood. This study examined core theorized ACT and broader ACT-consistent target processes as mediators of ACT versus minimally-enhanced usual care within a randomized trial for anxious cancer survivors in a community oncology setting. Method Two core theorized ACT target processes (experiential avoidance and values-aligned behavior, each measured with two instruments) and two broader ACT-consistent target processes (emotional approach coping and self-compassion) were analyzed at pre- and post-intervention as mediators of general anxiety symptoms, cancer-related trauma symptoms, and fear of cancer recurrence (N = 134). Results ACT led to greater increases on emotional approach coping (ps [less than or equal to] .001) and one measure of values-aligned behavior (ps [less than or equal to] .031), and marginal or greater improvement on self-compassion (ps [less than or equal to] .055), but not other core ACT target processes. Self-compassion and emotional approach coping mediated ACT's effects on cancer-related trauma symptoms (ps [less than or equal to] .037). Additionally, self-compassion, emotional approach coping, and values-aligned behavior marginally mediated fear of recurrence and general anxiety symptoms improvement (ps [less than or equal to] .088). Conclusion ACT reduced cancer survivors' anxiety-related symptoms, and especially cancer-related trauma symptoms, most consistently by promoting self-compassion and emotional approach coping. Author Affiliation: (a) Department of Psychology and Neuroscience, University of Colorado Boulder, 345 UCB, Boulder, CO, 80309, USA (b) Department of Psychology, University of California, 502 Portola Plaza, Los Angeles, CA, 90095, USA (c) Jonsson Comprehensive Cancer Center, University of California, 10833 Le Conte Ave, Los Angeles, CA, 90024, USA (d) Cousins Center for Psychoneuroimmunology, University of California, 300 Medical Plaza Driveway, Los Angeles, CA, 90095, USA (e) Department of Psychiatry and Biobehavioral Sciences, University of California, 757 Westwood Plaza #4, Los Angeles, CA, 90095, USA (f) Division of Cancer Prevention and Control, University of Colorado Cancer Center, 1665 Aurora Court, Aurora, CO, 80045, USA * Corresponding author. Article History: Received 5 April 2021; Revised 21 April 2022; Accepted 22 April 2022 Byline: Joel N. Fishbein [joel.fishbein@colorado.edu] (a,*), Charles M. Judd (a), Sarah Genung (a), Annette L. Stanton (b,c,d,e), Joanna J. Arch (a,f)

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Gale Document Number: GALE|A703074273