QOL-17. ASCENT: A population-specific ACT-based psychosocial intervention for patients with newly diagnosed malignant primary CNS tumors

Abstract BACKGROUND Patients with newly diagnosed malignant primary central nervous system (CNS) tumors experience significant distress related to their diagnosis and poor prognosis. Our prior qualitative work demonstrated that these patients often cope with distress through cognitive, emotional, and behavioral avoidance, which may hinder values-based living and portend worse psychological outcomes. Using principles of Acceptance and Commitment Therapy (ACT), we developed a population-specific intervention (“ASCENT”) aimed to reduce distress, improve coping, and promote values-driven behaviors. METHODS Building on our prior qualitative work and using ACT as a framework, our multidisciplinary team developed preliminary intervention modules targeting the areas of greatest patient distress and need. We then refined the proposed intervention content using input from an advisory council of patient and caregiver stakeholders. We additionally elicited expert input from neuropsychology and speech-language pathology colleagues to ensure accessibility for patients facing cognitive and/or communication challenges, which often affect patients with CNS tumors. RESULTS ASCENT is a six-session, psychosocial intervention consisting of weekly, one-on-one, 45–60-minute meetings with a trained clinician. Sessions build on core ACT principles, with key components including: defining the patient’s values, identifying obstacles to living by those values, practicing acceptance, mindfulness training, problem-solving and communication skills, and goal setting. Participants receive a manual containing session didactics and activities, with content and design features that accommodate patients with cognitive/communication limitations. We will refine the intervention based on stakeholder feedback and an upcoming open pilot study, prior to a randomized controlled trial to evaluate intervention feasibility and acceptability. CONCLUSION ASCENT represents a novel, population-specific approach using the tenets of ACT to address distress in patients with malignant primary CNS tumors, specifically tailored to facilitate participation of patients with cognitive and/or communication deficits. Findings from preliminary studies will inform future evaluation of ASCENT’s efficacy in improving psychological and behavioral outcomes.