{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:52:17Z","timestamp":1786978337095,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T00:00:00Z","timestamp":1765670400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People living longer with metastatic non\u2010small cell lung cancer (mNSCLC) experience heightened psychological distress and decrements in quality of life. Therefore, we developed LiveWell, an 8\u2010session adapted dialectical behavioral therapy skills training (DBT\u2010ST) protocol delivered one\u2010on\u2010one via telehealth to reduce psychological distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To conduct a single\u2010arm pilot trial examining the feasibility and acceptability of LiveWell and explore change in outcome variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients receiving systemic therapy for mNSCLC with at least mild distress participated. Outcomes were feasibility (accrual\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a030 in 18\u00a0months, &gt;\u00a080% sessions attended, &lt; 25% attrition) and acceptability (&gt;\u00a080% participant satisfaction). Distress (depression and anxiety symptoms; primary outcomes), intolerance of uncertainty, emotion regulation, illness acceptance, symptoms (e.g., fatigue, dyspnea, pain), skill use, and quality of life (secondary outcomes) were assessed at baseline, post\u2010intervention (primary endpoint), and 1\u2010month post\u2010intervention and examined with paired sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty participants (\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u00a0=\u00a063\u00a0years, 77% female) consented and completed the baseline assessment. LiveWell met feasibility (accrual\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a030 in 8\u00a0months, 93% sessions attended, 87% retention at post\u2010intervention) and acceptability (96% satisfaction) benchmarks. Participants demonstrated reductions in distress (depression\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.35, anxiety\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.22) from baseline to post\u2010treatment. Intolerance of uncertainty (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.71), emotion regulation (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.49), and illness acceptance (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.45) improved. Fatigue and pain remained stable or improved (\n                      <jats:italic>d<\/jats:italic>\n                      's 0.07\u20130.38). Skill use increased (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.65) and quality of life improved (\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0=\u00a00.21). Improvements were maintained or enhanced at 1\u2010month follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LiveWell was feasible and acceptable, and participants demonstrated promising improvement in primary and secondary outcomes. Findings support a larger randomized efficacy trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov Identifier: NCT04973436<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70357","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T05:17:38Z","timestamp":1765775858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["LiveWell: Pilot Feasibility Trial of an Adapted Dialectical Behavioral Therapy Skills Training Protocol in Patients With Metastatic Non\u2010Small Cell Lung Cancer"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-5306","authenticated-orcid":false,"given":"Kelly A.","family":"Hyland","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"},{"name":"Division of Bio\u2010Behavioral Medicine Department of Psychiatry and Behavioral Sciences Medical University of South Carolina  Charleston South Carolina USA"},{"name":"Hollings Cancer Center Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9779-7276","authenticated-orcid":false,"given":"Andrada D.","family":"Neacsiu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Brain Stimulation Research Center Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah M.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen M.","family":"Cowperthwait","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Stinchcombe","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin C.","family":"Oeffinger","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2962-2378","authenticated-orcid":false,"given":"Laura S.","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline S.","family":"Dorfman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis J.","family":"Keefe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara J.","family":"Somers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"American Cancer Society \u201cCancer Facts and Figures 2025 \u201d accessed 5 June 2025 https:\/\/www.cancer.org\/research\/cancer\u2010facts\u2010statistics\/all\u2010cancer\u2010facts\u2010figures\/2025\u2010cancer\u2010facts\u2010figures.html."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1916623"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S147895152200116X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2008.11.002"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/lctt.s120215"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.22.02212"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12123684"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ncc.0b013e318268f983"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2019.11.015"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2017.02.008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/jto.0b013e3182397b3e"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/0000395-016"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/go\u201024\u201000333"},{"key":"e_1_2_9_15_1","volume-title":"DBT\u00ae Skills Training Handouts and Worksheets","author":"Linehan M. M.","year":"2015"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psychotherapy.2015.69.2.97"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4135"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5214"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2024.01.006"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2019.05.001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare4030056"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2025.100592"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.12.062"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/psn.0000000000000018"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/qai.0b013e3181605df1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/ncc.0000000000000446"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000161"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1188\/17.ONF.329\u2010336"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488\u2010023\u201001274\u2010x"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0149\u20107189(79)90094\u20106"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191111411667"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010018\u20101803\u2010x"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2004.12.004"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23476"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10862\u2010016\u20109547\u20109"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1024929829627"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.93.3.580"},{"issue":"2","key":"e_1_2_9_39_1","first-page":"129","article-title":"Pain Assessment: Global Use of the Brief Pain Inventory","volume":"23","author":"Cleeland C. S.","year":"1994","journal-title":"Annals Academy of Medicine Singapore"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/0169\u20105002(95)00450\u2010f"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20685"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpra.2021.02.006"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.01.020"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010017\u20102031\u20108"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6259"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31100458"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12147"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806\u20109282.2024S115"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70357","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pon.70357","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70357","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T16:49:36Z","timestamp":1776012576000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.70357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":47,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/pon.70357"],"URL":"https:\/\/doi.org\/10.1002\/pon.70357","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-08-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70357"}}