The effect of acceptance and commitment therapy on communication avoidance, emotional well-being, and hyperarousal in Iranian caregivers of women with advanced breast cancer

BACKGROUND: Providing care to a family member who has been diagnosed with cancer can be quite tiresome both physically as well as psychologically; therefore, emotional preparedness within the family will contribute significantly in offering effective care. This study investigated the effects of acceptance and commitment therapy (ACT) on communication avoidance, emotional distress and hyper arousal among caregivers of patients with advanced breast cancer. METHODS: This study was a randomized controlled trial with pretest-posttest follow-up design. The study sample were 80 caregivers of advanced breast cancer patients from Mashhad City, Khorasan Province, Iran, in 2023, who were selected by the convenience sampling method. The research instruments included a demographic, communication avoidance, positive and negative affect, and hyperarousal questionnaire. Eight weeks of intervention was conducted following the pre-test. The post-test and follow-up were conducted one week and three month post intervention. The data were analyzed using repeated measures MANOVA. RESULTS: A statistically significant difference was observed between the intervention and control groups in the mean scores of communication avoidance, positive and negative affect, and hyperarousal questionnaire one week and three month after intervention. The intervention group demonstrated higher scores than the control in positive affect but lower in communication avoidance, negative affect, and hyperarousal. The intervention had a positive effect on the intervention group over time, with no significant differences observed between the post-test and follow-up stages (p < .001). CONCLUSION: According to these results, ACT was effective in reducing communication avoidance and negative emotions and decreasing hyperarousal among caregivers. Thus, results point to the potential of ACT to contribute not only to emotional regulation but also to healthier coping with the burden associated with providing cancer caregiving.