Tailored ACT+ may address psychological and supportive-care for cancer survivors

Advances in early diagnosis and cancer treatment mean that growing numbers of people are surviving cancer, with approximately 3.5 million people now living with and beyond the disease in the United Kingdom. Nevertheless, completing treatment does not always mean returning to life as it was before cancer. Survivors may experience persistent fatigue, fear of recurrence, emotional distress, loss of confidence, social isolation, and difficulties returning to work or other activities. Exercise, mindfulness-based programs, cognitive behavioral therapy, and acceptance and commitment therapy have shown potential for improving quality of life. However, post-treatment support remains inconsistent, and little qualitative research has examined how cancer survivors experience tailored ACT interventions or which components they find most useful.

A study (DOI: 10.48130/ejcc-0026-0008) published in European Journal of Cancer Care on 24 July 2026 by Anna Cheshire's team, University of Westminster, shows that mindfulness, committed action, adaptable delivery, and supportive therapist relationships were central to participants' positive experiences of ACT+.

The researchers conducted a qualitative process evaluation within the multicenter SURECAN randomized controlled trial, which compared ACT+ alongside usual aftercare with usual aftercare alone. Trial participants had completed cancer treatment with curative intent within the previous 24 months or were in long-term remission and had reported reduced quality of life. For the qualitative study, the team purposively selected people who had received at least four ACT+ sessions, seeking variation in cancer type, age, gender, and ethnicity. They interviewed 24 patients and five trained ACT+ therapists by telephone or Microsoft Teams. The interviews explored experiences of receiving or delivering ACT+, perceived effects, engagement barriers and facilitators, and contextual factors influencing participation. Transcripts were analysed in NVivo 14 using deductive themes based on the ACT+ model and inductive themes emerging from participants' accounts. Four overarching themes were identified: engagement with ACT+ processes; the practical delivery of ACT+ theory; positive cycles of psychological adaptation; and receptivity and relational influences affecting engagement. Mindfulness—particularly present-moment awareness—was the component most frequently discussed, with participants describing it as a way to step back from distressing thoughts, reduce anxiety, and respond less automatically to difficult emotions. "Doing what matters," especially committed action, was also prominent. Participants described breaking goals into manageable steps, resuming everyday routines, reconnecting with friends and partners, returning to creative activities, and making time for self-care.

Practical exercises, memorable metaphors, goal planning, and the ability to tailor sessions to individual circumstances strengthened engagement. Skilled, warm, and non-judgemental therapists were particularly influential because they helped participants feel safe, understood, and less isolated. However, experiences were not uniformly positive. Some participants found the 92-page manual overly long or difficult to use while experiencing fatigue or cognitive problems, and structured exercise or work-related goals were not suitable for everyone.

Overall, the study indicates that ACT+ may address psychological and supportive-care needs that can remain unmet after cancer treatment. Its benefits were perceived to arise not from a single technique but from the interaction of mindfulness, acceptance, values, manageable action, and a strong therapeutic relationship. The researchers emphasize that delivery should be paced and adapted to each survivor's health, readiness, and priorities. Future research should include people who discontinued therapy, examine different cancer and demographic groups, assess remote delivery, and explore whether simplified, co-designed resources could improve engagement and equitable access.

Source:

Chinese Academy of Sciences

Journal reference:

Cheshire, A., et al. (2026). ACT+ for patients living with and beyond cancer: an exploration of patient use of ACT+ components and therapist delivery. European Journal of Cancer Care. DOI: 10.48130/ejcc-0026-0008https://www.maxapress.com/article/doi/10.48130/ejcc-0026-0008