Table 1 Intervention components

A

Assessment and engagement

Warmth, empathy, positive regard. History taking, typical responses to transition, beginning baseline monitoring and introducing measurement protocol and concepts.

B

Workability

Review of typical responses and greater contact with the consequences, linking ineffective strategies with control, avoidance and cognitive fusion.

C

Awareness

Teaching awareness skills, linking to greater behavioural choice, mindfulness exercises, 5 senses experience, mindful eating a raisin, 10-min mindfulness audio exercise given for homework.

D

Openness

Demonstrating the greater effectiveness of willingness to have difficult thoughts and feelings and at the same time, stepping back from such inner experiences. Using leaves on the stream exercise, singing negative thoughts, speaking negative thoughts in a funny voice, perspective taking around thoughts, kick your buts exercise, ‘I’m having the thought that…’ exercise.

E

Engagement

Linking behavioural effectiveness with desired outcomes and qualities of actions, in order to live with purpose and meaning in the end stage of life. Concept of values, and actions, sweetspot exercise, the compass metaphor, generating hierarchies of difficult actions.

F

Review and ending (1 month follow up)

Review of progress after 4 weeks of no treatment, barriers to practice, anticipation of future challenges and how open, aware and engagement skills could be used, behavioural rehearsal of effective responses, commitments to next steps. Ending contact.