{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:29:59Z","timestamp":1787761799003,"version":"build-2784847793"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Online mindfulness\u2010based cognitive therapy (eMBCT) can reduce psychological distress in people with cancer, but adherence and scalability could be improved. Through co\u2010creation, we developed two eMBCT formats: group\u2010blended and individual\u2010unguided. This trial compared the effects of the two eMBCT to care as usual (CAU) on psychological distress and other mental health outcomes in people with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this parallel, three\u2010armed randomized controlled trial, people with cancer were randomly allocated to group\u2010blended eMBCT, individual\u2010unguided eMBCT, or CAU. Participants completed baseline, mid\u2010treatment, post\u2010treatment, and 3\u00a0months follow\u2010up assessments. The primary outcome analyzed in the intention\u2010to\u2010treat (ITT) population was psychological distress (Hospital Anxiety and Depression Scale) at post\u2010treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 186 participants were randomized to group\u2010blended eMBCT (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a057), individual\u2010unguided eMBCT (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a075), or CAU (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a054). Most participants were female (81%) with breast cancer (49%), and treated with curative intent (76%). In ITT analyses, group\u2010blended eMBCT participants reported significantly lower levels of psychological distress at post\u2010treatment (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.38) and follow\u2010up (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.64) than those receiving CAU, while individual\u2010unguided eMBCT participants only had significantly less psychological distress at follow\u2010up (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.48). Additionally, participants in group\u2010blended eMBCT had less rumination and greater mindfulness, decentering, and self\u2010compassion than those in CAU at follow\u2010up. Participants in individual\u2010unguided eMBCT had greater decentering than those in CAU at post\u2010treatment and follow\u2010up, and less rumination and greater mindfulness skills than CAU at follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared to CAU, both eMBCT conditions were effective in reducing psychological distress and could be an accessible, and potentially low\u2010cost intervention to reduce distress in people with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Dutch Registry CCMO, NL73117.091.20;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      , NCT05336916\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70286","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:19:01Z","timestamp":1758269941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Randomized Controlled Trial of Group\u2010Blended and Individual\u2010Unguided Online Mindfulness\u2010Based Cognitive Therapy to Reduce Psychological Distress in People With Cancer"],"prefix":"10.1002","volume":"34","author":[{"given":"Nasim","family":"Badaghi","sequence":"first","affiliation":[{"name":"Department of Psychiatry Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Kwakkenbos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Radboud University Medical Center  Nijmegen the 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Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Speckens","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601887"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010023\u201007675\u2010w"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.23.00857"},{"key":"e_1_2_9_6_1","volume-title":"Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness","author":"Kabat\u2010Zinn 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