Research

Therapies & Interventions | People & Contexts | Patient

Effect of third-wave cognitive behavioural interventions on biopsychosocial outcomes in people diagnosed with advanced cancer: A systematic review and meta-analysis of randomised controlled trials

Published: Mar 2025

Authors

Elizabeth Beasley, Victoria White, Anna Ugalde, Joanne Brooker, David Skvarc, Antonina Mikocka-Walus

Abstract

Objective:

People with advanced cancer experience elevated psychological morbidity and poor quality of life (QoL). The role of third-wave cognitive-behavioural therapy (CBT) interventions in addressing these needs has been examined, but not synthesised in a systematic review. The aim of this review is to systematically identify, analyse and review randomised controlled trials (RCTs) which examined the effect of third-wave CBT interventions on biopsychosocial outcomes (e.g., anxiety, pain, QoL) in this population.

Methods:

A systematic search was undertaken on MEDLINE, PsycInfo, CINAHL, Embase and Cochrane CENTRAL. Studies were included if they examined the effect of third-wave CBT interventions on biopsychosocial outcomes in adults living with advanced cancer in RCTs. The Cochrane Risk of Bias tool assessed risk of bias for each study. A random-effects model was fitted to the data and the restricted maximum-likelihood estimator was applied. The standardised mean differences (SMD) between control and experimental groups at short- and long-term follow up were used.

Results:

Twelve RCTs with 782 participants were identified. Meta-analyses demonstrated that third-wave CBT interventions were only more effective than comparator groups in the short-term improvement of QoL (SMD = 0.19, 95 % CI [0.00, 0.37], p < 0.05). The results of the 11 other meta-analyses did not reach statistical significance. Eight studies were classified as having unclear risk, and four were classified as high risk of bias.

Conclusions:

Third-wave CBT interventions may be effective in enhancing QoL in people with advanced cancer. However, more rigorous RCTs are needed to establish their efficacy in this population.

Access

Web link: https://doi.org/10.1016/j.jpsychores.2025.112106

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