Effect of Acceptance and Commitment Group Therapy on Quality of Life and Resilience of Women With Breast Cancer

Fatemeh sadeghi (1), Fariba Hassani (2), Suzan Emamipour (3), Hamidreza Mirzaei (4)
(1) Department of Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran, Iran, Islamic Republic of,
(2) Department of Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran, Iran, Islamic Republic of,
(3) Department of Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran, Iran, Islamic Republic of,
(4) Department of Psychology, Islamic Azad University, Central Tehran Branch, Tehran, Iran, Iran, Islamic Republic of


Background: Breast cancer diagnosis always causes a great deal of stress and results in significant changes in the patient’s routine life, which—apart from physical injuries—can lead to loss of social functioning and increased risk of mental disorders. Psychological resilience may be a protective factor in dealing with stressful clinical situations. The present study aimed at investigating the effect of acceptance and commitment group therapy on the quality of life and resilience of women with breast cancer.
Methods: This study had a quasi-experimental, pre-post intervention design with a control group. Twenty women with breast cancer (stages I or II) were randomly assigned to an intervention or a control group. The intervention consisted of eight weekly sessions of acceptance and commitment group therapy. Follow-up evaluations were carried out two months after the intervention. The Quality of Life Questionnaire-Core 30 (QLQ-C30), Quality of Life Questionnaire-Breast Cancer (QLQ-BR23), and the Connor-Davidson Resilience Scale (CD-RISC) were used in this study.
Results: Sixteen patients completed the study. Compared with the control group, significant improvements were observed in the total and subscale scores on QLQ-C30 (partial ?2 = 0.40), QLQ-BR23 (partial ?2 = 0.73), and CD-RISC scores (partial ?2 = 0.94) and (P < 0.01) in the intervention group.
Conclusion: Acceptance and commitment program appears to be an effective therapeutic intervention for improving quality of life and resilience of breast cancer patients. Therefore, we suggest that this intervention be provided along with medical treatments to improve quality of life and resilience of breast cancer patients.

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Irvin W, Jr., Muss HB, Mayer DK. Symptom management in metastatic breast cancer. Oncologist. 2011;16(9):1203-14.

Farahbakhsh K, Mokri Vala M. Mindfulness Based Breast Cancer Management. Review Study. Int J Chronic Dis Ther. 2016;2(6):48-51.

McGregor B, Ceballos R, Dolan E, Medic S, Albano D. 87. Cognitive behavioral stress management among women at elevated risk for breast cancer. Brain Behavior and Immunity. 2009(23):S49.

Medeiros MC, Veiga DF, Sabino Neto M, Abla LE, Juliano Y, Ferreira LM. Depression and conservative surgery for breast cancer. Clinics (Sao Paulo). 2010;65(12):1291-4.

Baqutayan SMS. The effect of anxiety on breast cancer patients. Indian journal of psychological medicine. 2012;34(2):119.

Reyes-Gibby CC, Anderson KO, Morrow PK, Shete S, Hassan S. Depressive symptoms and health-related quality of life in breast cancer survivors. J Womens Health (Larchmt). 2012;21(3):311-8.

Fiorentino L, Ancoli-Israel S. Insomnia and its treatment in women with breast cancer. Sleep Med Rev. 2006;10(6):419-29.

Holland AJ, Davidson PW, Prasher VP, Janicki MP. Assessment of Behavioral and Psychiatric Disorders. Oxford: Blackwell Science; 2008.

Rastegary F. The effectiveness of coping strategies on mental health and rumination of Females with breast cancer: Islamic Azad University of Karaj; 2014.

Lavdaniti M. Quality of Life in Cancer Patients- A Nursing Perspective . J Nurs Care. 2015;1:126-34.

Traore BM, El Fakir S, Charaka H, Benaicha N, Najdi A, Zidouh A, et al. Evolution of quality of life in patients with breast cancer during the first year of follow-up in Morocco. BMC Cancer. 2018;18(1):109.

Richardson LC, Wang W, Hartzema AG, Wagner S. The role of health-related quality of life in early discontinuation of chemotherapy for breast cancer. Breast J. 2007;13(6):581-7.

Lynch BM, van Roekel EH, Vallance JK. Physical activity and quality of life after colorectal cancer: overview of evidence and future directions. Expert Review of Quality of Life in Cancer Care. 2016;1(1):9-23.

Price MA, Bell ML, Sommeijer DW, Friedlander M, Stockler MR, Defazio A, et al. Physical symptoms, coping styles and quality of life in recurrent ovarian cancer: a prospective population-based study over the last year of life. Gynecol Oncol. 2013;130(1):162-8.

Di Giacomo D, Cannita K, Ranieri J, Cocciolone V, Passafiume D, Ficorella C. Breast cancer and psychological resilience among young women. J Psychopathol. 2016;3:9001-5.

Duggal D, Sacks-Zimmerman A, Liberta T. The Impact of Hope and Resilience on Multiple Factors in Neurosurgical Patients. Cureus. 2016;8(10):e849.

Strauss B, Brix C, Fischer S, Leppert K, Fuller J, Roehrig B, et al. The influence of resilience on fatigue in cancer patients undergoing radiation therapy (RT). J Cancer Res Clin Oncol. 2007;133(8):511-8.

Association. AP. Psychological Treatments: APA; 2017 [updated 2011 May 28. Available from: http://www.div12.org/psychological treatments/treatments/acceptance-and-commitment-therapy-for-psychosis.

Hayes SC, Strosahl K, Wilson KG. Acceptance and Commitment Therapy: An experiential approach to behavior change.: New York: Guilford Press.; 1999.

Low J, Serfaty M, Davis S, Vickerstaff V, Gola A, Omar RZ, et al. Acceptance and commitment therapy for adults with advanced cancer (CanACT): study protocol for a feasibility randomised controlled trial. Trials. 2016;17:77.

Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44(1):1-25.

Gladding ST. Counseling: A Comprehensive Profession. 7th ed: Savalan; 2013.

Fayers P, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. EORTC QLQ-C30 Scoring Manual (3rd edition). 3 ed. Brussels: European Organisation for Research and Treatment of Cancer,; 2001.

Gokgoz S, Sadikoglu G, Paksoy E, Guneytepe U, Ozcakir A, Bayram N, et al. Health related quality of life among breast cancer patients: a study from Turkey. Global Journal of Health Science. 2011;3(2):140.

Montazeri A, Harirchi I, Vahdani M, Khaleghi F, Jarvandi S, Ebrahimi M, et al. The EORTC breast cancer-specific quality of life questionnaire (EORTC QLQ-BR23): translation and validation study of the Iranian version. Qual Life Res. 2000;9(2):177-84.

Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82.

Mohammadi M. Investigating the Factors Affecting Resilience in Subjects at Risk of Substance Abuse. Tehran: University of Olume Behzisti and Tavanbakhshi; 2005.

Brassington L, Ferreira NB, Yates S, Fearn J, Lanza P, Kemp K, et al. Better living with illness: a transdiagnostic acceptance and commitment therapy group intervention for chronic physical illness. Journal of Contextual Behavioral Science. 2016;5(4):208-14.

Yalom ID, Vinogradov S. Bereavement Groups: Techniques and Themes. International Journal of Group Psychotherapy. 1988;38(4):419-46.

Forman EM, Chapman JE, Herbert JD, Goetter EM, Yuen EK, Moitra E. Using session-by-session measurement to compare mechanisms of action for acceptance and commitment therapy and cognitive therapy. Behavior therapy. 2012;43(2):341-54.

Dunkel-Schetter C, Feinstein LG, Taylor SE, Falke RL. Patterns of coping with cancer. Health psychology. 1992;11(2):79.

Johnston M, Foster M, Shennan J, Starkey NJ, Johnson A. The effectiveness of an Acceptance and Commitment Therapy self-help intervention for chronic pain. Clin J Pain. 2010;26(5):393-402.

Eren İ, Erdi Ö, Şahin M. The effect of depression on quality of life of patients with type II diabetes mellitus. Depression and anxiety. 2008;25(2):98-106.

Huang M-F, Courtney M, Edwards H, McDowell J. Factors that affect health outcomes in adults with type 2 diabetes: a cross-sectional study. International journal of nursing studies. 2010;47(5):542-9.

Matziou V, Tsoumakas K, Vlahioti E, Chrysicopoulou L, Galanis P, Petsios K, et al. Factors influencing the quality of life of young patients with diabetes. Journal of diabetes. 2011;3(1):82-90.

Karlin BE, Walser RD, Yesavage J, Zhang A, Trockel M, Taylor CB. Effectiveness of acceptance and commitment therapy for depression: comparison among older and younger veterans. Aging Ment Health. 2013;17(5):555-63.

Kahl KG, Winter L, Schweiger U. The third wave of cognitive behavioural therapies: what is new and what is effective? Current opinion in psychiatry. 2012;25(6):522-8.

Dionne F, Blais M, Monestes J. Acceptance and commitment therapy in the treatment of chronic pain. Sante mentale au Quebec. 2013;38(2):131-52.

Wicksell RK, Olsson GL, Hayes SC. Mediators of change in acceptance and commitment therapy for pediatric chronic pain. Pain. 2011;152(12):2792-801.

Ernst MM, Mellon MW. Acceptance and Commitment Therapy (ACT) to Foster Resilience in Pediatric Chronic Illness. Child and Adolescent Resilience Within Medical Contexts: Springer; 2016. p. 193-207.

Burton NW, Pakenham KI, Brown WJ. Feasibility and effectiveness of psychosocial resilience training: a pilot study of the READY program. Psychology, health & medicine. 2010;15(3):266-77.

Towsyfyan N, Hossein Sabet F. The Effectiveness of Acceptance and Commitment Therapy on the Improving of Resilience and Optimism in Adolescents with Major Depressive Disorder. International Journal of Humanities and Social Science. 2017;7(3):239-45.

Badiee D. Investigating the Effectiveness of Acceptance and Commitment Therapy in Resiliency and Functioning of Family with Children suffering from Mental Retardation. The Caspian Sea Journal. 2016;10(1):313-9.

Thompson RW, Arnkoff DB, Glass CR. Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma. Trauma Violence Abuse. 2011;12(4):220-35.

Butler J, Ciarrochi J. Psychological acceptance and quality of life in the elderly. Qual Life Res. 2007;16(4):607-15.

Forman EM, Herbert JD, Moitra E, Yeomans PD, Geller PA. A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior modification. 2007;31(6):772-99.


Fatemeh sadeghi
Fariba Hassani
Faribaahasssani@gmail.com (Primary Contact)
Suzan Emamipour
Hamidreza Mirzaei
sadeghi F, Hassani F, Emamipour S, Mirzaei H. Effect of Acceptance and Commitment Group Therapy on Quality of Life and Resilience of Women With Breast Cancer. Arch Breast Cancer [Internet]. 2018 Aug. 1 [cited 2024 May 23];5(3):111-7. Available from: https://archbreastcancer.com/index.php/abc/article/view/184

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