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Table 1 Summary of core components of each intervention condition

From: Acceptance and commitment therapy for fatigue interference in advanced gastrointestinal cancer and caregiver burden: protocol of a pilot randomized controlled trial

Acceptance and commitment therapy Education/support
•Discuss current attempts to control fatigue (if patient) or difficult thoughts and feelings (if caregiver) and their impact on quality of life
•Practice mindfulness with the therapist during sessions and at home (e.g., awareness of the breath, body scan, leaves on a stream)
•Practice cognitive defusion—noticing symptoms, thoughts, and feelings without being overwhelmed by them (e.g., passengers on the bus metaphor)
•Observe and detach from difficult internal experiences (e.g., fatigue, thoughts, feelings) to cultivate a transcendent sense of self from which to notice and accept changing experiences
•Identify important values (e.g., being a loving and engaged parent, serving one’s community)
•Goal setting and practice of value-based actions
•Orientation to the medical center and treatment team; provide overview of quality-of-life concerns and discuss physical quality of life and symptoms
•Discuss cancer-related social challenges (e.g., talking with children about cancer, employment concerns); tips on managing the household when ill; describe resources for addressing social challenges
•Discuss common emotional reactions to cancer, including anxiety, depression, and stress, and cancer-related cognitive changes and describe available mental health services
•Review common financial challenges related to cancer and its treatment and describe resources for addressing these challenges
•Discuss methods of evaluating health information on the Internet and other modalities
•Review previous session topics and refer to websites with cancer information