# Feasibility of an ACT-based group intervention for Malaysian breast cancer survivors with chronic pain

## TL;DR

This study explores whether a group therapy based on Acceptance and Commitment Therapy (ACT) is feasible and helpful for Malaysian breast cancer survivors dealing with chronic pain.

## Contribution

The study introduces a culturally adaptable ACT-based group intervention tailored for Malaysian breast cancer survivors with chronic pain.

## Key findings

- Participants found the ACT intervention understandable, accessible, and helpful in managing pain-related distress.
- The intervention improved psychological flexibility, allowing participants to engage in meaningful activities despite pain.
- Logistical and cultural barriers were identified, suggesting the need for delivery format refinements.

## Abstract

Breast cancer survivors frequently experience chronic pain, which can impair daily functioning and overall quality of life. This single-arm feasibility study examined the acceptability and preliminary effects of a group-based Acceptance and Commitment Therapy (ACT) intervention among Malaysian breast cancer survivors with chronic pain.

Twelve participants were enrolled (age range 45–62 years; M = 55.3), and nine completed the full intervention. The programme consisted of eight weekly 90-minute sessions facilitated by a clinical psychologist with a minimum of three years of clinical experience. The intervention targeted key ACT processes, including acceptance of difficult internal experiences, present-moment awareness/mindfulness, and values-guided behavioural action. Acceptability was assessed using qualitative feedback on clarity, relevance, and perceived usefulness.

Participants reported that the intervention was understandable, accessible, and helpful in increasing awareness of the interaction between pain and emotion, as well as in strengthening confidence to manage illness-related distress. Participants also described greater psychological flexibility to live with pain while remaining engaged in personally meaningful activities. Reported barriers included logistical constraints (e.g. travel, scheduling), perceived intensity of weekly sessions, and the need for further cultural adaptation of language and examples. Pain intensity following the intervention was rated at 2.89/10 (SD = 1.27). Pre-intervention pain ratings were not collected; therefore, conclusions regarding change in pain severity over time are limited.

Nonetheless, the pattern of feedback and completion suggests that a brief, psychologist-led ACT group is both feasible and acceptable in this population. Overall, these findings support the viability of ACT as a culturally adaptable psychosocial approach for Malaysian breast cancer survivors with chronic pain. Refinements to delivery format and contextual tailoring are recommended, and a randomized controlled trial is warranted to evaluate longitudinal clinical outcomes.

https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12624000542594p, identifier ACTRN12624000542594p.