Table 2 Format, aims and content of the ACTION intervention
Session | Aim | Indicative content |
|---|---|---|
Individual session (60 min) | - Assessment of psychological flexibility - Relationship building - Identify some clinically relevant behaviours - Provide a simple formulation | - Explanation of ACT and the ACTION intervention - Conversations exploring a) ongoing treatment and breast cancer experiences and how challenging experiences are managed b) where participants values might lie - Communication of a psychological flexibility formulation - Highlight the ACTION website including ideas for managing side-effects Home practice - ‘Getting to your core values’ exercise - ‘What do you do with difficult feelings?’ exercise |
Group session 1 (90 min) | - Enhance awareness of thoughts, feelings and actions - Introduce a values-based framework for making decisions - Introduce ways to relate to difficult thoughts and feelings | - Education: normalising emotional responses to challenging events - Discussion of ‘What do you do with difficult feelings?’ exercise - Introducing defusion to support living with challenging thoughts: - Experiential defusion practice, e.g. ‘thoughts as hands’ exercise ‘I am having the thought that … ’ exercise Home practice - Defusion diary: noticing what thoughts tend to draw one in and practicing defusing from them |
Group session 2 (90 min) | - Develop deeper awareness of values - Consider hormone therapy decisions while considering values - Introduce willingness skills | - Reflection on the ‘Getting to your core values’ exercise - Values compass - Personal reflection on: ‘what is the smallest possible step you could do to get in touch with your values’ - Reflection on whether treatment adherence or side-effect management is a values-consistent behaviour - ‘Passengers on the bus’ exercise Home practice Smallest possible step exercise Defusion diary |
Group session 3 (90 min) | - Enhance awareness of getting caught up in unhelpful stories - Introduce ideas for stepping back from stories - Reinforce new useful skills | - ‘Notice who is noticing’ exercise - ‘Letting go of unhelpful labels’ exercise - Reflection on what has and has not been useful over the course of the intervention. Reminder of the website including ideas for managing hormone therapy side effects |