What question did this study set out to answer?

The study aims to determine how ACT affects helplessness and quality of life in breast cancer patients.

March 7, 2026Open Access

Acceptance and commitment therapy improves the quality of life of breast cancer patients by reducing helplessness: a randomized controlled trial

Key Points

The study aims to determine how ACT affects helplessness and quality of life in breast cancer patients.
Conducted a two-arm, parallel, single-blind RCT with 80 breast cancer patients.
Assigned participants to ACT (40) or treatment-as-usual (TAU, 40).
Administered assessments at baseline, post-intervention (4 weeks), and follow-up (12 weeks).
Delivered ACT over four weekly sessions and analyzed data using repeated-measures ANOVA.
Sixty-six participants completed all assessments.
ACT significantly reduced helplessness and improved overall quality of life compared to TAU (p < 0.05).
Improvements were maintained at the 12-week follow-up.

Abstract

Abstract Background Breast cancer imposes substantial psychosocial challenges, with helplessness being a key determinant of reduced quality of life (QoL). Acceptance and Commitment Therapy (ACT) has shown promise in improving psychological flexibility, but its role in targeting helplessness and enhancing QoL in breast cancer patients has not been fully established. This randomized controlled trial (RCT) examined the effects of ACT on helplessness, QoL, and their domains. Methods This two-arm, parallel, single-blind RCT recruited 80 breast cancer patients from a tertiary care center and randomly assigned them to either ACT ( n = 40) or treatment-as-usual (TAU, n = 40). Participants completed the Malay Illness Cognition Questionnaire (ICQ-M) and the Functional Assessment of Cancer Therapy (General and Breast Cancer modules) at baseline (T1), post-intervention at 4 weeks (T2), and follow-up at 12 weeks (T3). ACT was delivered in four weekly sessions between T1 and T2. Data were analyzed using repeated-measures analysis of variance (ANOVA). Results Sixty-six participants completed all assessments (ACT, n = 32; TAU, n = 34). Compared with TAU, ACT significantly reduced helplessness and improved overall QoL and all QoL domains across time points (all p < 0.05). Effects were maintained at 12-week follow-up. Conclusion ACT is an effective psychosocial intervention for breast cancer patients, producing sustained improvements in QoL partly by reducing helplessness. Integrating ACT into supportive and palliative care may address critical psychological mechanisms affecting patient well-being. Trial registration ClinicalTrials.gov, NCT05327153. Registered on April 6, 2022.

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