Group Based Acceptance and Commitment Therapy (ACT) for Improving Wellbeing following Primary Medical Intervention for Breast Cancer: A Follow-up Randomised Control Trial

Eligible participants will receive 6 x 1.5 hr group-based Acceptance and Commitment Therapy delivered weekly by one psychologist with experience in ACT interventions, supported by a co-facilitating psychologist with experience in psycho-oncology. Group size will be at a maximum of 8 participants per group. The sessions will involve psycho-education, group discussion and group activities (e.g. mindfulness). Adherence will be through attendance logs, text message reminders that participants reply to, and observation by co-facilitators. The intervention will be based off an ACT protocol used by Feros, Lane, Ciarrochi, and Blackledge (2013) developed by recognised trainers in ACT. This protocol contains a therapist manual and a client manual that provides structure in the form of four modules targeting ACT processes: increasing effective action orientation, mindfulness, self as context, and formal value clarification and commitment. These are divided into four modules: Module 1 – Letting go of unhelpful struggles and making room for living; Module 2 – How we get stuck in our minds and lose sight of our lives as it’s happening now; Module 3 – You are more than your pain, you are more than your suffering, you are more than your cancer; and Module 4 – Moving towards a vital, meaningful life with your pain. Each module contains activities based around metaphors and participants are encouraged to write their responses to session activities and homework readings in their workbook. As there is an emphasis on the protocol on process rather than content, each activity can be modified based on group understanding and ability in order to target the process. The manual outlines 9 x 60-minute individual sessions. In a previous unpublished pilot study, this manual was adapted for a 6-week, 90-minute group therapy format.