Efficacy of the cognitively-based compassion training (cbct®) program for the improvement of quality of life and fear of cancer recurrence in a sample of breast cancer survivors

Resumen

There is growing evidence of how compassion training enhances psychological and physical well-being (Zessin, Dickhäuser, & Garbade, 2015), however, there are very few studies analyzing the efficacy of Compassion-Based Interventions (CBI) on breast cancer survivors (BCS) (Dodds et al., 2015). A vast body of research evaluating the effects of psychosocial interventions on psychological adaptation during cancer treatment has been done (Antoni, 2013; Guo et al., 2013; Stanton, 2006; Stanton, Luecken, MacKinnon, & Thompson, 2013). During the last decade, a growing number of empirical data for new intervention approaches has arisen (Goldstein et al., 2005; Richardson, Sanders, Palmer, Greisinger, & Singletary, 2000). In oncological settings, Mindfulness-Based Interventions (MBI) have proved their efficacy in promoting well-being and quality of life domains (Sinatra & Black, 2018; Zainal, Booth, & Huppert, 2013), constructive coping strategies when dealing with psychosocial stress related to the disease, relieving anxiety, stress, fatigue, general mood, sleep disturbance (Carlson et al., 2003; Carlson & Garland, 2005). In the last decade, Compassion-Based Interventions have shown to improve psychological functioning and well-being in clinical and educational settings (Kirby, Tellegen, & Steindl, 2015; Kirby, 2017). The main aim of this study is to analyze the efficacy of Cognitively-Based Compassion Training (CBCT) Program in a Randomized Clinical Trial (RCT) on a sample of BCS. The specific objectives are aimed to analyze the efficacy of CBCT in variables related to quality of life (QoL), psychological symptomatology, psychological dimensions linked to fear of cancer recurrence (FCR), self-compassion, compassion and mindfulness trait facets and the influence of CBCT over participants’ compassion and self-compassion semantic construct, when compared to a treatment as usual (TAU) control group. Hypothesis of this study predicts that CBCT group will show improvement in all of the variables showed above. Moreover, participants’ semantic construction, of what is a compassionate and self-compassionate individual, will be modified in the direction of what CBI and compassion-based contemplative traditions propose after going through the CBCT program. An RCT was designed. Participants (n = 56) were randomly assigned to CBCT (n = 28) or a treatment-as-usual control group (n = 28). Pre-post intervention and 6-month follow-up measures took place to evaluate the variables listed above in both intervention and wait-list groups. CBCT was effective in diminishing stress caused by fear of FCR (F [2, 96.863] = 3.521, p < .05), fostering self-kindness (F [2, 97.453] = 5.769, p < .01) and common humanity (F [2, 98.323] = 6.161, p < .01), and increasing overall self-compassion scores (F [2, 96.277] = 5.423, p < .01), mindful observation (F [2, 96.052] = 4.709, p < .05), and acting with awareness skillsets (F [2, 98.598] = 3.444, p < .05). CBCT also proved to influence participants’ mental construction of what is a self-compassionate and compassionate being. This research project is another call for deepening scientific knowledge and paying more attention to the mechanisms and implications of training in compassion and exploring the potential of these type of programs for cancer survivorship contexts.