Table 1

Intervention outline

SessionOutlineACT process targeted
Session 1
(patient)
  • Self-introduction and introduction of purpose of the programme and basic rules (completion of mindful exercise).

  • Help understand the impacts of cancer-related in the process of suffering from advanced lung cancer and the costs of controlling related thoughts and feelings with cancer-related fatigue (metaphor: The man in the hole).

  • Master alternative strategies to cope with cancer-related fatigue and distressing thoughts, feelings and feelings more effectively (experiential exercise: Pink elephant).

  • Master the strategies of focusing on the present moment (completion of be focused exercise).

  • Assign homework. (1) continuation of mindfulness diary; (2) keep the practice log, consolidate strategies of acceptance and focus on the present moment.

Contact with the present moment.
Acceptance
Session 2
(patient)
  • Brief mindfulness exercise.

  • Previous session and homework review.

  • Help separate the thoughts/feelings related to the cancer-related fatigue experiences from the facts (mindful exercise; metaphor: Passengers on the bus; experiential exercise: Labelling your thoughts; Milk, Milk, Milk).

  • Help observe themselves in an objective way, treat the diagnosis of advanced lung cancer and thoughts/feels/feelings related to distressed experience objectively (experiential exercise: The sky and the weather).

  • Assign homework. (1) continuation of mindfulness diary; (2) keep the practice log, consolidate strategies of acceptance, defusion, self-as-context and focus on the present moment.

Contact with present moment.
Cognitive defusion.
Self-as-context
Session 3
(caregiver)
  • Brief mindfulness exercise.

  • Help understand the impacts of psychological distress in the process of caregiving patients and the costs of controlling related thoughts and feelings (impacts on quality of life) (metaphor: The man in the hole).

  • Master alternative strategies to cope with psychological distress and distressing thoughts, feelings and feelings related to caregiving more effectively (experience exercise: Pink elephant).

  • Master the strategies of focusing on the present moment (completion of be focused exercise).

  • Assign homework. (1) continuation of mindfulness diary; (2) keep the practice log, consolidate strategies of acceptance and focus on the present moment.

Contact with the present moment.
Acceptance
Session 4
(caregiver)
  • Brief mindfulness exercise.

  • Previous session and homework review.

  • Help separate the thoughts/feelings related to the distressing caregiving experience from the facts (mindful exercise; metaphor: Passengers on the bus; experiential exercise: Labelling your thoughts; Leaves on the rive).

  • Help observe themselves in an objective way, treat the diagnosis of advanced lung cancer and thoughts/feels/feelings related to caregiving experience objectively (experiential exercise: The sky and the weather).

  • Assign homework. (1) continuation of mindfulness diary; (2) keep the practice log, consolidate strategies of acceptance, defusion, self-as-context and focus on the present moment.

Contact with present moment.
Cognitive defusion.
Self-as-context
Session 5
(patient and caregiver)
  • Brief mindfulness exercise.

  • Previous session and homework review.

  • Understand the difference between values and goals.

  • Clarify personal values and their importance (experiential exercise: 80th Birthday; Value compass).

  • Setting one value-based smallest goal in SMART format (specific, measurable, achievable, relevant and time-bound) for both patient and caregiver.

  • Assign homework. (1) continuation of mindfulness diary; (2) keep the action worksheet along with you and commit yourself to action.

Contact with present moment.
Values
Session 6
(patient and caregiver)
  • Brief mindfulness exercise.

  • Previous sessions and homework review.

  • Further clarify personal values and goals.

  • Share own values with each other to promote their action.

  • Summary and feedback.

Contact with present moment.
Committed action
  • ACT, acceptance and commitment therapy.