The Development and Process Evaluation of a 3-Day Acceptance and Commitment Therapy Group Program for Adolescent Cancer Survivors

Abstract

Background Adolescents diagnosed with cancer experience unique psychosocial concerns that persist beyond treatment completion into longer-term survivorship. Camp-based, group Acceptance and Commitment Therapy (ACT) programs are a potential model for providing evidence-informed psychological and peer support to adolescent cancer survivors. Objective This paper describes the development and exploration of the feasibility and acceptability of such a program, Places You'll Go. This manualised program incorporates five 90-min group ACT sessions within a 3-day camp, teaching ACT strategies in the context of psychosocial impacts of cancer. Method Eight facilitators and twenty-eight Australian adolescent cancer survivors (68% female; age range 12-17 years, M = 15.4 years) participated in the program and evaluation. Feasibility was assessed using facilitator-reported session duration, attendance, quality and content fidelity; facilitators also completed interviews after program completion. Young people completed surveys on program acceptability at the end of each session and at program completion. Results All planned sessions were delivered, with 97% attendance and high fidelity in manualised program delivery. All young people were mostly or very satisfied and would recommend the program to another cancer survivor. Opportunities for peer connection and skill development contributed to perceived program acceptability. Conclusions The Places You'll Go program was acceptable and feasible to deliver. It is a promising community-based model for promoting peer support and well-being in adolescent cancer survivors, indicating the potential of ACT-based approaches for this population. Further work is underway to evaluate whether the program improves psychosocial wellbeing among participants, and if this is linked to the therapeutic mechanisms underpinning ACT.

What helps distressed Australian adolescents impacted by cancer? Mechanisms of improvement of the PEER program

“…The evidenced mechanisms of the effect of the PEER program provide further evidence to support the use of ACT and self‐compassion as therapeutic approaches when working with adolescents impacted by their own or a family member's cancer, particularly those experiencing higher levels of distress. Whilst previous literature evidences the benefits of these approaches for young people (Bluth et al, 2016 ; Bluth & Eisenlohr‐Moul, 2017 ; Ernst & Mellon, 2016 ; Halliburton & Cooper, 2015 ; Rodgers et al, 2018 ; Swain et al, 2015 ), people with cancer (Feros et al, 2013 ; Hulbert‐Williams et al, 2015 ) and those at the intersection of these groups (Campo et al, 2017 ; Patterson, McDonald, Ciarrochi, et al, 2017 ; Patterson et al, 2019 ; Patterson, McDonald, Kelly‐Dalgety, Luo, & Allison, 2021 ) has been relatively limited, these approaches were considered promising for this population because of their focus on non‐judgemental and compassionate acceptance of difficult thoughts and feelings brought on by cancer (Clarke et al, 2020 ; González‐Fernández & Fernández‐Rodríguez, 2019 ; Hayes et al, 2006 ; Hulbert‐Williams et al, 2015 ; Ing et al, 2019 ). Struggling with difficult thoughts and feelings is a reasonable response to the challenging life circumstance of a cancer diagnosis that is beyond one's control; being able to accept and live well with these emotions and cognitions, rather than engaging in the futility of trying to challenge or change them, may be more adaptive.…”

“…Residential (multi‐day/overnight, live‐in) programs have been identified as a promising format of psychosocial intervention for adolescents impacted by cancer, as they combine the chance to ‘escape’ the immediate cancer situation with opportunities for peer connection, support and learning coping strategies (Clarke et al, 2021 ; Hancock, 2011 ; Martiniuk et al, 2014 ; Patterson, McDonald, Kelly‐Dalgety, Lavorgna, et al, 2021 ; Patterson, McDonald, Kelly‐Dalgety, Luo, & Allison, 2021 ; Wu et al, 2011 ). Whilst some previous evaluation research has evidenced the potential for such programs to improve psychosocial well‐being (e.g.…”

“…These processes have been linked to improved psychosocial well‐being in adolescents (Halliburton & Cooper, 2015 ), including those with chronic health conditions (Ernst & Mellon, 2016 ) such as cancer (Patterson & McDonald, 2015 ), and offspring impacted by parental cancer (Patterson, McDonald, White, et al, 2017 ). Indeed, ACT has been identified as particularly promising for cancer‐affected populations (Clarke et al, 2020 ; González‐Fernández & Fernández‐Rodríguez, 2019 ; Ing et al, 2019 ), where difficult emotions and cognitions may be reasonable responses to ongoing health risks and challenges (e.g. fear of cancer recurrence) and where learning to live with these internal processes may better facilitate adjustment to the cancer situation (Hulbert‐Williams et al, 2015 ).…”

Effect Evaluation of Mental Nursing in Nursing of Young Cancer Patients Based on Big Data

“…Cancer is one of the deadly diseases and it requires high levels of care, love, and attention. Due to the fragmentation and lack of coordination of healthcare professionals, patients with cancer feel extremely low and thus it impacts their effectiveness of nursing (21,27,28). Prior research suggests that physical exercises enhance the strength of those patients who are specifically suffering from lung cancer.…”

“…Young patients find these physical symptoms extremely odd, and hence they affect their living standards of patients. Commonly identified symptoms are eating disorders, pain, sleeping disorders, fatigue, and changes in physical appearance (14,17,28). Nevertheless, the most frequently reported physical symptom is fatigue, which is experienced during the diagnosis period, hospitalization period, and recovery period.…”