Table 1 REFRESH session goals and objectives

1

n/a

Understanding fatigue

To provide information and psycho-education about cancer-related fatigue including medical and psychosocial causes of CRF, and explanation of CBT and its role in CRF. Introduction to an activity diary for tracking fatigue

2

1

Understanding feelings

To understand the impact of emotions on fatigue and strategies to increase pleasant emotions. Introduction to relaxation strategies (breathing, muscle relaxation and mindfulness)

3

2

Helpful behaviours

To understand the role of behaviours in impacting fatigue. Mood monitoring, increasing physical activity, pacing and scheduling pleasant and mastery activities for the week ahead as part of behavioural activation

4

3

Adaptive thinking

To understand the role of cognitions in influencing emotions, behaviour and fatigue. Identifying unhelpful thoughts and ‘thinking traps’, cognitive restructuring via use of a thought diary. Introduction to worry postponement strategy and coping statements

5

4

Moving on

Summarise skills learnt and identify which are helpful and can be implemented ongoing. Assistance with developing a coping card if this hasn’t been done prior. Assistance with identifying additional supports. Assistance with accessing further professional supports if needed