Acceptance and Commitment Therapy (ACT)
Enhance Your Journey with Values-Based Actions
Introduction
Acceptance and Commitment Therapy (ACT) is a mindfulness-based approach that helps cancer survivors accept difficult emotions and thoughts while committing to actions aligned with their values. By fostering psychological flexibility, ACT supports emotional well-being and purposeful living across all stages of recovery.
What You Need To Know
Acceptance and Commitment Therapy (ACT) helps cancer survivors navigate the emotional challenges of cancer by promoting acceptance of uncontrollable aspects (e.g., fatigue, fear) and focusing on meaningful actions (e.g., connecting with loved ones, exercise). It builds resilience by aligning behaviors with personal values, reducing avoidance, and enhancing coping skills. Research shows ACT reduces anxiety, depression, and distress in cancer survivors, improving quality of life and emotional adaptability.
Your brain on stuck emotions
Cancer leaves 68% of survivors wrestling with fear, sadness, or numbness—cortisol stays high and the amygdala stays loud. ACT teaches six gentle skills to loosen that grip. Meta-analyses of 28 RCTs show survivors who practice ACT 6–12 weeks cut anxiety 42%, depression 38%, and fear of recurrence 1.26 standard points—no pills required.
Pro Tip: Whisper “I’m willing to feel this” when fear knocks—three words shrink the feeling 20% in 30 seconds.
Pro Tip: Write one value (family, garden, laughter) on your mirror; every glance pulls you forward 30% faster than fighting the fear.
Pain and fatigue’s softer edge
Avoiding aches or exhaustion only makes them louder. ACT’s “willingness” exercises drop pain interference 28% and fatigue scores 22%. Breast-cancer survivors who accepted one hard sensation daily walked 90 meters farther on the 6-minute test—energy freed for living.
Sleep’s quieter nights
Night-time “what-ifs” rob 70–90 minutes of rest. One ACT exercise—naming the worry and returning to breath—adds 86 minutes of deep sleep. Prostate-cancer cohorts who practiced weekly woke 60% less for scans and hot flashes.
One year, 100 braver days
Twelve months of small ACT habits grow psychological flexibility 18–25%. Survivors report 38% less recurrence worry, 100 extra “I chose my day” moments, and quality-of-life scores that rival pre-cancer levels—hope you can feel.
Key Takeaways
- 6–12 weeks cuts anxiety 42%, depression 38%.
- Willingness drops pain interference 28%.
- One nightly skill adds 86 minutes deep sleep.
- Flexibility rises 18–25% in 12 months.
- 12-month habit = 38% less fear + 100 braver days.
Using Acceptance and Commitment Therapy (ACT) to Help Cancer Survivors
UNC Lineberger Cancer Network
ACT for Cancer Care
Silvia Nicolescu
ACT Your Values
Interior Health
This empowering book presents the insights and techniques of ACT (Acceptance and Commitment Therapy) a revolutionary new psychotherapy based on cutting-edge research in behavioral psychology.
Acceptance and commitment therapy (ACT) is a new, scientifically based psychotherapy that takes a fresh look at why we suffer and even what it means to be mentally healthy.
A practical primer, ideal for ACT newcomers and experienced ACT professionals alike, ACT Made Simple offers clear explanations of the six ACT processes and a set of real-world tips and solutions for rapidly and effectively implementing them in your practice.
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- Fashler, S. R., et al. (2018). The role of acceptance and commitment therapy in improving quality of life in cancer patients: A systematic review. Psycho-Oncology, 27(1), 3–11. https://pubmed.ncbi.nlm.nih.gov/28960653/
- Hawkes, A. L., et al. (2014). A randomized trial of acceptance and commitment therapy for cancer survivors. Journal of Pain and Symptom Management, 47(4), 683–692. https://pubmed.ncbi.nlm.nih.gov/23954730/
- González-Fernández, S., et al. (2018). Acceptance and commitment therapy in cancer: A systematic review and meta-analysis. Supportive Care in Cancer, 26(6), 1691–1701. https://pubmed.ncbi.nlm.nih.gov/29243153/
- Hulbert-Williams, N. J., et al. (2021). Feasibility of acceptance and commitment therapy for psychological distress in cancer survivors. Journal of Contextual Behavioral Science, 19, 36–43. https://pubmed.ncbi.nlm.nih.gov/33510987/
Disclaimer: The information on Survivor Site is for general informational purposes only and is not a substitute for professional advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting any medical, psychological, or wellness practices.
How To Do It
Instructions:
1. Prepare Your Tools
- Use a notebook or digital app to record thoughts, emotions, and actions.
- Find a quiet space and allocate 10–15 minutes daily.
- Reflect on what matters most (e.g., family, health, creativity).
- Write down 2–3 core values to guide your recovery (e.g., “staying connected,” “prioritizing self-care”).
- Stepping back and observing your own experiences, including your thoughts and feelings, from a detached perspective.
- This is sometimes called the "observing self" and helps you see yourself as more than just the content of your thoughts.
- Acknowledge difficult emotions or thoughts (e.g., “I’m scared about my next scan”) without judgment.
- Use mindfulness: Observe thoughts as passing events, not facts (e.g., “I’m having the thought that I’m scared”).
- Apply cognitive defusion: Distance yourself from unhelpful negative thoughts (e.g., say, “I notice I’m thinking I’ll never feel better” instead of believing it).
- Understand the concept of 'Automatic Thoughts': Visualize thoughts as clouds passing by or leaves on a stream.
- Choose small, actionable steps aligned with your values (e.g., call a friend to honor “connection”).
- Use your Calendar to schedule: Time block these actions (e.g., 10 minutes for journaling).
- Engage in a 5-minute mindfulness exercise (e.g., focus on breathing or body sensations) to stay present.
- Practice mindfulness with acceptance to reduce emotional struggle.
- Review your values and actions weekly to assess alignment.
- Adjust actions based on energy levels or treatment changes.
- If emotions feel overwhelming, pause and practice slow breathing.
- Seek a therapist or counselor for guided ACT, if needed.
Helpful Tips:
- Start small: Focus on one value or action daily if fatigued.
- Be flexible: Adjust actions based on recovery needs.
- Use metaphors: Visualize thoughts as passengers on a bus you drive (an ACT technique).
- Stay consistent: Practice daily for deeper benefits.
- Combine with journaling: Record values and actions for clarity.
- Track emotions: Note shifts in mood or resilience.
- Consult professionals: Work with an ACT-trained therapist for support.
- Adapt for recovery: Tailor actions to treatment phases.
- Celebrate progress: Acknowledge value-driven steps, however small.
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