Feasibility of a virtual Focused Acceptance and Commitment Therapy (FACT) protocol for the emotional consequences of living with cancer: lessons learned and future practices

OBJECTIVE: Distress management guidelines emphasize the importance of addressing psychological symptoms in cancer patients. Mental health interventions that are time-bound are more easily integrated into oncology care. We tested the feasibility of a time-bound Focused Acceptance and Commitment Therapy (FACT) protocol for anxiety, depression, and psychological flexibility in cancer patients. METHODS: Breast, prostate, stage III/IV colorectal cancer, or leukemia patients who scored ≥5 on the PHQ-9 and/or GAD-7 were included. The intervention group completed three virtual FACT sessions; controls received written FACT exercises and phone check-ins. All received a one-month follow-up call. Feasibility was mixed: 57.1% of prescreened patients met screening eligibility (64/112), but overall conversion from initially interested patients was 27.8% (64/230). Per Red-Amber-Green criteria, enrollment was 100% (64/64; green/go) and retention was 42.2% (27/64; red/major redesign). Acceptability was high across groups. CONCLUSION: Initial recruitment was strong and clinical need was clear. Low retention highlights a need to improve procedures to support engagement among a high-burden population. Because ease of access is critical, we will apply lessons learned to refine the protocol.