Acceptance and Commitment Therapy (ACT) and Self Efficacy theory
Evidence shows that living with cancer can create challenges that can make it harder to seek support (1). People living with a diagnosis of cancer are at risk of experiencing psychological and emotional challenges. Around one-third of those diagnosed with cancer will experience compromised psychological health such as major depression, generalised anxiety disorder or adjustment disorder (2). Certain techniques can help people manage challenging thoughts and feelings that may be triggered by their experience of cancer, reducing the psychological and emotional impact (3,4,5).
CAN-EMPOWER is informed by two theoretical approaches: Acceptance and Commitment Therapy (ACT) and Self-Efficacy theory.
What is Acceptance and Commitment Therapy (ACT)?
ACT is an ‘action-oriented’ approach rooted in behaviour therapy approaches including cognitive behaviour therapy (CBT). It seeks to encourage people to stop avoiding, denying, and struggling with their inner emotions and instead notice these thoughts and feelings as understandable responses to certain situations. ACT is suitable for concerns and worries facing people with lived experience of cancer as it draws on mindfulness to enable people keep in contact with the present moment, notice thoughts, defuse unhelpful thoughts and identify what is important for them (6).
Self-efficacy theory
Self-efficacy is the belief and confidence in your own capabilities to plan and carry out actions to achieve specific outcomes (7). Evidence shows that, with appropriate support, people can self-manage challenges related to cancer and its treatment and experience restoration of their well-being (8). This can be achieved by using behavioural techniques to enhance self-efficacy, help resolve difficulties and self-manage the impact of cancer on everyday life. Higher self-efficacy is associated with greater effort and persistence to address obstacles and enhance well-being. Lower self-efficacy is associated with poorer quality of life and potentially more symptoms (9).
What this evidence shows is that noticing thoughts and identifying what is important, coupled with self-belief, confidence and adopting behavioural techniques that promote self-efficacy, can support people with lived experience of cancer to restore and enhance their well-being and reduce the likelihood of experiencing psychological and emotional difficulties.
References
- Foster C, Calman L, Grimmett C, Breckons M, Cotterell P, Yardley L, Joseph J, Hughes S, Jones R, Leonidou C, Armes J, Batehup L, Corner J, Fenlon D, Lennan E, Morris C, Neylon A, Ream E, Turner, L and Richardson A. Managing fatigue after cancer treatment: development of RESTORE, a web-based resource to support self-management. Psycho-Oncology 24: 940–949 (2015) Published online 2 February 2015 in Wiley Online Library DOI: 10.1002/pon.3747
- Maguire P. (2000) Psychological aspects. In: ABC of Breast Diseases (ed. Dixon M.), pp. 150–153. BMJ Books, London, UK.
- Fillion L., Gagnon P., Leblond F., Gelinas C., Savard J., Dupuis R., Duval K. & Larochelle M. (2008) A brief intervention for fatigue management in breast cancer survivors. Cancer Nursing 31, 145–159.
- Hunter M.S., Coventry S., Hamed H., Fentiman I. & Grunfeld E.A. (2008) Evaluation of a group cognitive behavioural intervention for women suffering from menopausal symptoms following breast cancer treatment. Psycho-Oncology 18, 560–563
- Department of Health (2011) Improving Outcomes: A Strategy for Cancer. DH Publications, London, UK.
- Hulbert-Williams N J, Storey L, Wilson K G (2015) European Journal of Cancer Care 24, 15–27 Psychological interventions for patients with cancer: psychological flexibility and the potential utility of Acceptance and Commitment Therapy
- Bandura A (1986) Social Foundations of Thought and Action: A Cognitive Social Theory. Prentice Hall: Englewood Cliffs, New York
- Foster C, Fenlon D. Recovery and self-management support following primary cancer treatment. Br J Cancer 2011;105(S1): S21–S28
- Lorig KR et al. Chronic disease self-management program—2-year health status and health care utilization outcomes. Med Care 2001;39(11):1217–1223.