Table 1

Detailed content for the conquer fear intervention
Session Content Home based practice
1 • FCR-specific assessment; • Examine values identified in session and devise relevant goals (e.g. if identified value is “being physically fit” devise realistic ways to achieve this and identify barriers to achieving goal);
• Model on which treatment is based is explained;
• Discussion of existential changes brought about by cancer;
• Values clarification exercise
• Reflect on past experiences and how these have shaped response to cancer.
2 • Discuss impact of potential vulnerability factors (e.g., past traumatic events) on FCR; • Practice ATT on a daily basis throughout the remainder of the intervention and document in diary.
• Discuss rationale and practice of the Attention Training Technique (ATT), a technique designed to help patients reduce their tendency to ruminate and shift their attention more flexibly when thoughts about recurrence occur.
3 • Introduce the practice of Detached Mindfulness, designed to enhance meta-awareness of cognition and the ability to become an objective observer of the content of thoughts without the need for evaluation or reaction. • Continue daily practice of ATT;
• Practice application of detached mindfulness on response to thoughts which trigger FCR.
4 • Provide information about possible symptoms of recurrence of breast or colorectal cancer; • Continue daily practice of ATT;
• Provide guidelines to help clients distinguish those from benign physical complaints; • Practice detached mindfulness in response to emerging thoughts about FC;
• Reassess self-examination practices and medical surveillance;
• Identify avoidant or excessive behaviours; • Devise an appropriate plan based on best available evidence about how to respond to new symptoms;
• Develop a behavioural contract to help clients to engage in recommended levels of self-examination and follow-up tests (if needed);
• Discuss beliefs that underpin FCR (eg. beliefs about the benefits of FCR, or beliefs about physical harm caused by FCR); • Practice worry postponement.
• Test the validity of these beliefs through Socratic dialogue.
• Introduce worry postponement as a technique for responding to residual worries
5 • Review goal setting task;
• Consolidate skills learned throughout the program;
• Develop relapse prevention plan.

Butow et al.

Butow et al. BMC Cancer 2013 13:201   doi:10.1186/1471-2407-13-201

Open Data