Qualitative Findings Following Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence


  • Christine Shepler Indiana University School of Medicine
  • Elizabeth Cottingham Regenstrief Institute, Inc.
  • Patrick Stutz Indiana University School of Medicine
  • Shelley Johns Indiana University School of Medicine




Background: Fear of cancer recurrence (FCR) takes an emotional toll on cancer survivors and significantly undermines quality of life following treatment. During a randomized controlled trial of Acceptance and Commitment Therapy (ACT) for post-treatment breast cancer survivors with clinically significant FCR, we conducted qualitative interviews to glean a deeper understanding of the impact of ACT on survivors’ coping with FCR. 

Methods: Breast cancer survivors (stage I-III) who had completed a 6-week ACT intervention were invited to share their experiences in semi-structured qualitative interviews. Interviews were transcribed verbatim and analyzed thematically using a deductive approach. Participants received a $25 gift card for their time. Participants (n=16) were primarily White (81.3%) and college educated (68.8%), with a mean age of 57.3 (SD=11.1) and 75% had an income over $50,000.   

Results: Prior to the study, survivors generally coped with FCR by denying their FCR or by attempting to control their fears through faith, lifestyle management, avoidance, and positivity. Survivors uniformly noted the sense of community they felt in their ACT group when listening to other survivors describe their own struggle with FCR. This common bond created a foundation that allowed survivors to embrace the ACT intervention and develop adaptive coping skills related to acceptance, present-moment awareness, and living consistently with one’s values. Survivors noted that these skills reduced the negative impact of FCR and other life challenges and improved quality of life compared to pre-study coping techniques. 

Conclusion and Potential Impact: By building trust with other cancer survivors, participants were able to shift from attempts to ‘control’ FCR to a more ‘accepting’ approach to manage FCR and other life stressors. While research with a larger group of participants is needed, initial findings indicate that ACT may be a promising addition to care for cancer survivors. 

Author Biography

Shelley Johns, Indiana University School of Medicine

Regenstrief Institute, Inc.