Applying acceptance-based therapies to help people live well after cancer treatment
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Background With advances in medical treatments, the numbers of cancer survivors have grown considerably over recent years. Following completion of cancer treatment, patients can experience a range of physical and psychological difficulties, particularly around critical transition phases such as adjustment to survivorship. One of the most common difficulties cited by cancer survivors is that of fear of cancer recurrence (FOR). Existing treatments for improving psychological wellbeing in this population appear to offer limited efficacy, and there are very few interventions directly targeting FOR. Acceptance-based approaches, with an underlying aim of improving psychological flexibility, offer one novel alternative approach to addressing these difficulties. Methods This thesis presents a systematic review and meta-analysis of the literature in relation to the effectiveness of acceptance-based interventions for post treatment cancer survivors, with a particular focus on Mindfulness-Based Interventions (MBI). A cross sectional questionnaire study is then reported which explores the potential role of psychological flexibility in mediating the relationship between FOR and distress and quality of life (QoL)outcomes. Results The findings of the review offer tentative support for the effectiveness of MBI in reducing stress and depressive symptoms, while less convincing results emerged for anxiety. Results from the empirical study suggest that while psychological flexibility does not appear to significantly mediate the impact of FOR on distress and QoL, value based living and cognitive fusion did emerge as significant mediating variables within these relationships. Conclusions Findings suggest that acceptance-based approaches, may be of benefit in reducing the burden of distress and improving the lives of cancer survivors. Supporting cancer survivors to become less entangled with their thoughts and live in accordance with their values may be particularly beneficial. Further studies using larger samples and longitudinal designs are warranted.