Coping skills training and acceptance and commitment therapy for symptom management: Feasibility and acceptability of a brief telephone-delivered protocol for patients with advanced cancer.

Patients with advanced cancer face a life-limiting condition that brings a high symptom burden that often includes pain, fatigue, and psychological distress. Psychosocial interventions have promise for managing symptoms, but need additional tailoring for these patients' specific needs. Patients with advanced cancer in the community also face persistent barriers - availability of interventions in community clinics, financial and illness-related factors - to accessing psychosocial interventions.The aim of the current study was to assess the feasibility and acceptability of telephone implementation of Engage, a novel, brief combined Coping Skills Training and Acceptance and Commitment Therapy protocol, for reducing symptoms and increasing quality of life in community patients with advanced cancer.Adult patients with advanced cancer receiving care in the community received Engage, four, sixty-minute manualized telephone sessions delivered by a trained psychotherapist and completed pre- and post-treatment assessments.Engage was feasible, achieving 100% accrual (N=24) of a heterogeneous sample of patients with advanced cancer, with good retention (88% completed). Acceptability was demonstrated via satisfaction (mean=29 out of 32, SD=2), engagement (95% attendance) and use of skills. Secondary analyses pointed to reductions in pain interference, fatigue, psychological distress, and improvements in psychological acceptance and engagement in value-guided activity at post treatment.Engage, our brief novel combined Coping Skills and Acceptance and Commitment Therapy intervention, demonstrated initial feasibility and acceptability when delivered over the telephone, and increased access for community clinic patients with advanced cancer. Future research will assess the comparative efficacy of Engage in larger randomized trials.