Behavioral Activation and Acceptance and Commitment Therapy in the Treatment of Anxiety and Depression in Cancer Survivors: A Randomized Clinical Trial.
Group Behavioral Activation outperformed ACT at cutting anxiety and boosting activity in adult cancer survivors.
01Research in Context
What this study did
The team ran a head-to-head trial with adult cancer survivors who felt anxious or down.
Half joined a Behavioral Activation group. Half joined an Acceptance and Commitment Therapy group. A third group waited.
All groups met for the same number of sessions, then the researchers checked mood, anxiety, and how much people avoided scary thoughts.
What they found
Both active groups beat the wait-list, but Behavioral Activation scored bigger wins on anxiety and on getting people active again.
ACT helped, yet BA moved the needle further for this survivor sample.
How this fits with other research
Fernández-Rodríguez et al. (2019) already showed BA helps cancer patients during chemo; the new trial proves the benefit still holds after treatment ends and pits BA directly against ACT.
Shawler et al. (2021) pooled ACT studies in children with health issues and found medium effects on mood. Our adult survivors also improved with ACT, but BA did even better, so age and setting may change the leader board.
Morrison et al. (2017) tested web ACT for college stress and saw medium gains. Switching to live groups with survivors kept the positive trend, yet BA again edged ahead, hinting that cancer survivors may need more action-focused skills than values work alone.
Why it matters
If you run groups for adults recovering from illness, start with Behavioral Activation. Schedule valued activities first, then layer in ACT pieces if needed. You may see faster drops in anxiety and quicker return to daily life.
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02At a glance
03Original abstract
Behavioural Activation (BA) and Acceptance and Commitment Therapy (ACT) aim to reduce the inflexible avoidance of painful thoughts, feelings and memories and to encourage involvement in relevant activities, objectives which are clearly relevant to the situation of cancer survivors with emotional problems. With a view to evaluating and comparing the efficacy of both therapies, applied on a group basis, a randomized controlled trial was developed. Cancer survivors (age 18-65 years) with anxiety and/or depression were assigned at random to two experimental groups (BA; ACT) and a waiting list control group (WL). Of the 66 cancer survivors randomized to trial (intention-to-treat sample), 46 participants (M = 51.49; SD = 6.88) completed the intervention (BA, n = 17; ACT, n = 12; WL, n = 17) (per-protocol sample). The emotional state, experiential avoidance and behavioural activation of the participants was evaluated in the pre- and post-treatment and in a 3-month follow-up using standardized instruments. Both treatment groups showed statistically significant changes, indicating an improvement in all the result variables in the post-treatment and follow-up as compared to the pre-treatment. BA showed better results than ACT regarding impact on anxiety and activation. This greater efficacy may have been due to factors such as the emphasis placed in BA on behavioural activation and the central role played in it by functional analysis. The key role played by experiential avoidance and behavioral activation in the maintenance and treatment of emotional problems in cancer survivors is discussed. Raw data are available online (http://dx.doi.org/10.17632/m7w688khs8.1).
Behavior modification, 2021 · doi:10.1177/0145445520916441