Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer
Open accessAbstract
Objectives: Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress. Methods: Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%. Results: At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials. Conclusions: This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting. This study was pre-registered on the Open Science Framework (Ref: 46,033) and retrospectively registered on the ISRCTN registry (Ref: ISRCTN12084782).
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The BAM is a SCED-oriented three-item measure of psychological flexibility including openness to experience, awareness, and valued action.
“The brief acceptance measure (BAM) is a SCED-oriented three-item measure of psychological flexibility including openness to experience, awareness, and valued action and typically takes up to three minutes to complete [95,96].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [96]
The Method section (Procedure and outcome assessments; page not provided) describes the BAM as a three-item measure of psychological flexibility used for daily assessments in a SCED study. It assigns openness to experience, behavioural awareness, and valued action to the separate component scores of the 23-item CompACT, not to the BAM; it does not specify the BAM’s three item contents. (LLM, conf=0.88)
Experimental — accuracy not yet measuredRecruitment was lowest (19% of eligible consented) in a UK study involving participants recently referred to a hospice service.
“The studies reporting the lowest levels of recruitment involved participants recently referred to a hospice service in the UK (19% of those eligible consented), 57”
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 [57]
Three studies showed improvements in quality of life, one study reported significant improvements.
“Three studies showed improvements in quality of life add53,55,57, one study reported significant improvements. 53”
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 [57]
In one hospice-based study, 4 of 10 participants recruited died during the study.
“In one study, 4 of 10 participants recruited died during the study 57”
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 [57]
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- Authors
- Hulbert-Williams, N. J., Norwood, S. F., Gillanders, D., Finucane, A. M., Spiller, J., Strachan, J., Millington, S., Kreft, J., & Swash, B.
- Affiliations
- University of Chester (GB)
- University of Edinburgh (GB)
- Marie Curie (GB)
- ORCID
- Venue
- BMC Palliative Care
- Published
- 2021-06-25
- Volume
- 20
- Issue
- 1
- Pages
- 96-96
- ISSN
- 1472-684X (ISSN-L)
- PMC
- PMC8235846
- OpenAlex
- W3174094277
- Cited by
- 17
- References
- 38
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 7
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Palliative Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Edge Hill University Research Information Repository (Edge Hill University) (publishedVersion, other-oa)
- ChesterRep (University of Chester) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Funders
- Macmillan Cancer Support
- Marie Curie
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- acceptance and commitment therapy, brief psychological intervention, hospice care, palliative care, advanced cancer, quality of life, psychological distress, treatment acceptability, transition to palliative care, single-case experimental design
- MeSH terms
- Mentoring, Feasibility Studies, Hospices, Humans, Neoplasms, Quality of Life, Acceptance and Commitment Therapy
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