{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:21:20Z","timestamp":1788999680863,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010506","name":"Indiana University Health","doi-asserted-by":"publisher","award":["0952"],"award-info":[{"award-number":["0952"]}],"id":[{"id":"10.13039\/100010506","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["K05CA175048"],"award-info":[{"award-number":["K05CA175048"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001377","name":"Walther Cancer Foundation","doi-asserted-by":"publisher","award":["0175.01"],"award-info":[{"award-number":["0175.01"]}],"id":[{"id":"10.13039\/100001377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer\u00a0survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence\u2010based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group\u2010based ACT for FCR in BCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Post\u2010treatment BCS (91 patients with stage I\u2010III disease) with clinical FCR randomly were assigned to ACT (6\u00a0weekly 2\u2010hour group sessions), survivorship education (SE; 6\u00a0weekly 2\u2010hour group sessions), or enhanced usual care (EUC; one\u00a030\u2010minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post\u2010traumatic stress, depression, QOL, and other FCR\u2010related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1\u00a0month after the intervention (T3), and 6\u00a0months after the intervention (T4) using intent\u2010to\u2010treat analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within\u2010group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between\u2010group differences at T4 substantially favoring ACT over SE (Cohen <jats:italic>d<\/jats:italic> for effect sizes, 0.80; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) and EUC (Cohen <jats:italic>d<\/jats:italic>, 0.61; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01). For 10 of 12 secondary outcomes, only ACT produced significant within\u2010group reductions across all time points. By T4, significant moderate to large between\u2010group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR\u2010related psychological distress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Group\u2010based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.32518","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T11:47:47Z","timestamp":1568980067000},"page":"211-218","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":131,"title":["Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3\u2010arm pilot randomized controlled trial"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5730-1822","authenticated-orcid":false,"given":"Shelley A.","family":"Johns","sequence":"first","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indiana"},{"name":"Center for Health Services Research Regenstrief Institute, Inc. Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-7641","authenticated-orcid":false,"given":"Patrick V.","family":"Stutz","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasneem L.","family":"Talib","sequence":"additional","affiliation":[{"name":"Center for Health Services Research Regenstrief Institute, Inc. Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7928-6491","authenticated-orcid":false,"given":"Andrea A.","family":"Cohee","sequence":"additional","affiliation":[{"name":"Indiana University School of Nursing Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen A.","family":"Beck\u2010Coon","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indiana"},{"name":"Indiana University School of Nursing Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda F.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura R.","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Department of Behavioral Medicine and Psychiatry West Virginia University School of Medicine Charleston West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick O.","family":"Monahan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L.","family":"LaPradd","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6153-0713","authenticated-orcid":false,"given":"Victoria L.","family":"Champion","sequence":"additional","affiliation":[{"name":"Indiana University School of Nursing Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy D.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine Indiana University School of Medicine Indianapolis Indiana"},{"name":"Research and Clinical Trials Indiana University Simon Cancer Center Indianapolis Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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