In a groundbreaking study published in BMC Psychiatry, researchers have explored the potential of internet-based Acceptance and Commitment Therapy (ACT) as a novel intervention for patients battling breast cancer. This trial delves into how digital psychological support might influence patients’ acceptance of their illness, improve emotional regulation, and alleviate the severity and interference of cancer-related symptoms. The investigation sheds new light on integrating technology-driven therapeutic approaches in oncological care.
Acceptance and Commitment Therapy, rooted in mindfulness and behavioral change principles, aims to help individuals embrace difficult experiences rather than avoid them. Traditionally administered in-person, this study’s innovation lies in delivering ACT via group video calls, making therapy accessible and scalable amid the digital transformation of healthcare. This approach is especially compelling for breast cancer patients, who often face emotional turmoil and persistent physical symptoms that disrupt daily functioning.
The randomized clinical trial adopted a semi-experimental design involving 36 breast cancer patients. Participants were sourced from the Maxa Center in Isfahan and then randomly assigned to either the experimental group undergoing ACT or a control group receiving general education and support through virtual sessions. Each therapy session lasted an hour and spanned ten weeks, ensuring comprehensive engagement and consistent exposure to the intervention.
Data collection was structured at three critical timelines: baseline (pre-intervention), immediately post-treatment, and a 12-week follow-up. This schedule allowed researchers to capture both the short-term and potential sustained impacts of the internet-based ACT. The study employed validated checklists and questionnaires targeting key outcome metrics—acceptance of illness, emotional regulation difficulties, severity of symptoms, and how these symptoms interfere with various aspects of patients’ daily lives.
One of the most intriguing findings concerns the acceptance of illness. While patients undergoing internet-based ACT reported increased acceptance over time relative to controls, these differences did not reach statistical significance. This subtlety suggests that while digital ACT may nudge patients towards greater psychological acceptance, larger-scale or longer-duration interventions might be necessary to produce robust effects in this domain.
Conversely, the trial yielded compelling evidence that online ACT significantly ameliorates difficulties in emotion regulation. Breast cancer patients often grapple with intense emotions, including anxiety, sadness, and fatigue. The therapeutic focus on mindfulness and value-driven commitment appears to equip patients with strategies to better navigate these emotional challenges, reducing overall distress and enhancing psychological resilience.
Symptom severity formed another crucial pillar of analysis. The experimental group exhibited marked reductions in psychological symptoms such as fatigue, anxiety, and sadness. Importantly, these improvements were statistically significant and sustained across the study timeline. Physical symptoms like pain and sleep disturbances also declined, although these trends were present in both groups, implying a combined effect of time and general support mechanisms.
Symptom interference—how symptoms disrupt core functions like mood, social relationships, and daily activities—is a critical barometer of quality of life. Although patients receiving internet-based ACT showed higher rates of improvement in symptom interference, the findings did not achieve statistical significance. This outcome hints at the complexity of symptom management in cancer care and underscores the necessity for multifaceted therapeutic strategies.
A notable aspect of the study is its focus on delivering psychological support remotely. Telehealth interventions have gained immense momentum, particularly in the wake of the COVID-19 pandemic, as they overcome barriers related to accessibility and convenience. This trial reinforces the viability of virtual platforms for conducting structured psychotherapy, even in populations coping with severe medical conditions.
From a methodological standpoint, the use of multivariate repeated measures ANOVA allowed the researchers to thoroughly examine the interaction effects of treatment and time. This statistical rigor adds credibility to the findings, ensuring that observed changes are attributed with confidence to the intervention rather than external variables or chance.
The study’s limitations, however, warrant consideration. The sample size, limited to 36 participants, restricts generalizability and the power to detect smaller effect sizes. Future research could benefit from larger cohorts, diversified demographics, and potentially incorporating biomarker assessments to explore physiological correlates of psychological change.
Importantly, the ethical framework guiding the trial was robust. Approval was secured from the ethics committee of the School of Medicine – Isfahan University of Medical Sciences, and the study was duly registered with the Iranian Registry of Clinical Trials. This adherence to ethical norms ensures participant welfare and scientific integrity throughout the research process.
In conclusion, this research marks a significant step forward in integrating internet-based psychological therapies in oncology. It suggests that Acceptance and Commitment Therapy, when delivered virtually, holds promise in mitigating emotional distress and symptom burden among breast cancer patients. While some outcomes did not reach statistical significance, the overall trend underscores the therapeutic potential of digital ACT and merits further exploration through expansive, multi-center trials.
The convergence of psychological science and digital health technologies offers exciting frontiers, particularly for chronic disease management where sustained patient engagement is challenging. As healthcare ecosystems increasingly embrace telemedicine, interventions like internet-based ACT could become pivotal tools in holistic cancer care, enhancing not only survival but also the quality of life for millions of patients worldwide.
Subject of Research: The effectiveness of internet-based Acceptance and Commitment Therapy on acceptance of illness, emotion regulation, symptom severity reduction, and symptom interference with function in patients with breast cancer.
Article Title: The effectiveness of internet-based acceptance and commitment therapy on acceptance of illness, emotion regulation, symptom severity reduction, and symptoms interference with function in patients with breast cancer
Article References:
Mirzaei, S., Bagherian-Sararoudi, R., Emami, M.H.D. et al. The effectiveness of internet-based acceptance and commitment therapy on acceptance of illness, emotion regulation, symptom severity reduction, and symptoms interference with function in patients with breast cancer. BMC Psychiatry 25, 599 (2025). https://doi.org/10.1186/s12888-025-06823-2
Image Credits: AI Generated
DOI: https://doi.org/10.1186/s12888-025-06823-2
