Coping Skills Training and Acceptance and Commitment Therapy for Symptom Management: Feasibility and Acceptability of a Brief Telephone-Delivered Protocol for Patients With Advanced Cancer
Open accessAbstract
Context Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers-availability of interventions in community clinics as well as financial and illness-related factors-to accessing psychosocial interventions.Objectives The aim of the present study was to assess the feasibility and acceptability of telephone implementation of Engage, a novel brief combined Coping Skills Training and Acceptance and Commitment Therapy protocol, for reducing symptoms and increasing quality of life in community patients with advanced cancer.Methods Adult patients with advanced cancer receiving care in the community received Engage, four 60-minute manualized telephone sessions delivered by a trained psychotherapist and completed pretreatment and post-treatment assessments.Results Engage was feasible, achieving 100% accrual (N = 24) of a heterogeneous sample of patients with advanced cancer, with good retention (88% completed). Acceptability was demonstrated via satisfaction (mean 29 of 32; SD 2), engagement (95% attendance), and use of skills. Secondary analyses pointed to reductions in pain interference, fatigue, psychological distress, and improvements in psychological acceptance and engagement in value-guided activity after treatment.Conclusion Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.
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Only two of five studies examining pain interference showed improvements (40%), one pre/post study and one RCT, both not statistically significant.
“Only two of five of the studies examining pain interference showed improvements (40%), one pre/post study 52 and one RCT 16 showed improvements that were not significant.”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [52]
The Methods and Results (Secondary Outcomes; page unavailable) identify this as a pre/post, single-arm feasibility study and report a small improvement in pain-related interference. The available passages do not establish that the change was statistically nonsignificant. Nor does this paper establish the citing document’s count of two improvements among five studies; the separate RCT is attributed to citation 16. (LLM, conf=0.83)
Experimental — accuracy not yet measuredSix studies showed improvements in valued living post intervention, although only one RCT showed statistically significant improvements.
“Six studies showed improvements in valued living post intervention,46,52,60,63,66 although only one RCT showed statistically significant improvements. 66”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [52]
The Results (Secondary Outcomes; page unavailable) report small post-intervention improvements in values-based action, supporting this paper’s inclusion among studies showing improvement. But the same passage calls it a small, single-arm feasibility trial, not an RCT; it does not support the statistically significant RCT finding attributed to citation 66 or establish the count of six studies. (LLM, conf=0.88)
Experimental — accuracy not yet measuredFollowing ACT, participants in most studies reported improvements in psychological flexibility, anxiety, and depression.
“Following Acceptance and Commitment Therapy, participants in most studies reported improvements in psychological flexibility,46,52,53,55,57,61–63,66,68 anxiety,16,52–54,63,66 and depression.16,52–54,63,66”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [52]
The Results (Secondary Outcomes; page unavailable) report small, exploratory improvements in psychological distress, acceptance, and values-based action. The Methods (Measures; page unavailable) show that distress was assessed with anxiety and depression questions, but the reported results do not establish separate improvements in each. This was also a single-arm trial combining ACT with coping skills training, so it cannot isolate the effects of ACT. (LLM, conf=0.84)
Experimental — accuracy not yet measuredOur results in combination with prior research provide a strong rationale for large-scale trials of ACT to reduce symptom interference in advanced cancer and promote feasible engagement in activities that enrich quality of life.
“Our results in combination with prior research10–13 provide a strong rationale for large-scale trials of ACT to reduce symptom interference in advanced cancer and promote feasible engagement in activities that enrich quality of life.”
From Symptom experiences in advanced cancer: Relationships to acceptance and commitment therapy constructs (2021) · cites this paper as [13]
The Introduction describes ACT as an approach to reducing symptom interference and supporting engagement in valued activities. The Discussion calls for larger randomized trials, but the intervention this paper tested combined ACT with coping skills training; its results do not establish the effects of ACT alone. (LLM, conf=0.84)
Experimental — accuracy not yet measuredTwelve studies (80%) reported patient satisfaction rates with their interventions.
“Twelve studies (80%) reported patient satisfaction rates with their interventions16,49,52–54,57,60 –63,66,68”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [52]
Retention was highest (88%) for a study using an individual telephone-based intervention with sessions lasting 45 minutes.
“Retention was highest (88%) for a study which used an individual telephone based intervention with sessions lasting 45 min, removing barriers of in-person intervention such as illness and travel. 52”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [52]
Six of the 15 intervention studies examined feasibility and acceptability as one of their stated outcomes.
“Six of the 15 intervention studies examined feasibility and acceptability as one of their stated outcomes.16,52,55,60,61,63”
From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [52]
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Intervenciones en el manejo de ansiedad y depresión en pacientes Paliativos oncológicos
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Dorfman, C. S., Somers, T. J., Arrato, N. A., Winger, J. G., Herold, B., Vilardaga, J. P., Chou, N. A., Diachina, A. K., Corbett, C. M., Wagner, L. M., et al. (2026) · Journal of Adolescent and Young Adult Oncology · doi:10.1177/21565333261425871
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- Authors
- Plumb Vilardaga, J. C., Winger, J. G., Teo, I., Owen, L., Sutton, L. M., Keefe, F. J., & Somers, T. J.
- Affiliations
- Duke Medical Center (US)
- Duke-NUS Medical School (SG)
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2020-02
- Volume
- 59
- Issue
- 2
- Pages
- 270-278
- ISSN
- 0885-3924 (ISSN-L)
- PMC
- PMC7393998
- OpenAlex
- W2974376060
- Cited by
- 36
- References
- 60
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 3
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Nursing Research (U24NR014637)
- American Cancer Society
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- advanced cancer, symptom management, coping skills training, acceptance and commitment therapy, telephone-delivered intervention, feasibility, acceptability, pain interference, fatigue, psychological distress, quality of life
- MeSH terms
- Adaptation, Psychological, Adult, Feasibility Studies, Humans, Neoplasms, Quality of Life, Telephone, Acceptance and Commitment Therapy
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