Table 2.
Summary of Adapted Session Content.
| Smart-3RP Content | Adapted Content Targeting FOR |
|---|---|
| Session 1: Stress Management and Resiliency Training The science of mind-body medicine, breath awareness, single-pointed meditation, energy battery | •Targeted opening quotes to managing uncertainty a |
| •Added information about cancer-related uncertainty, FOR, and healthcare engagement as they relate to stress and resiliency in cancer survivorship | |
| •Targeted relaxation practice (i.e., preface encouraging survivors to make adjustments as needed to accommodate late effects of cancer treatments, discussion question about applying relaxation practice before, during, or after a healthcare visit) a | |
| •Targeted energy battery to FOR and healthcare engagement behaviors | |
| Session 2: Relaxation Response (RR) Body scan, sleep hygiene, stress signals, MINI RR, autogenic feedback | •Added information about FOR and cancer-related insomnia |
| •Incorporated NCCN Survivorship guidelines for sleep | |
| •Targeted “stress signals” exercise to “Signs of FOR and stress” | |
| •Condensed between-session practice (e.g., removed biodot activity) | |
| Session 3: Stress Awareness Mindfulness, mindful eating, identifying positive emotions and sensations, social support | •Targeted mindfulness to FOR and certainty of present experiences |
| •Added “worry time” to limit interference of rumination on daily activities and to reduce fear avoidance | |
| •Targeted positive emotions/sensations exercise to identify changes before vs. after cancer treatment | |
| •Targeted social support needs to cancer survivorship (e.g., cancer-related information, insurance) | |
| Session 4: Mending Mind and Body Yoga, automatic thoughts, cognitive distortions, walking meditation | •Targeted rationale for applying meditative movement to manage FOR (i.e., certainty of present experience, nonjudgment of change moment-to-moment) |
| •Targeted examples of negative automatic thoughts to FOR | |
| Session 5: Creating an Adaptive Perspective Guided imagery, coping log, adaptive perspectives, acceptance, nutrition, stop breathe reflect and choose | •Targeted guided imagery exercise to FOR |
| •Incorporated NCCN Survivorship guidelines for nutrition | |
| •Targeted adaptive perspectives and acceptance strategies to FOR (e.g., self-compassion, patience, acceptance about survivorship involving tolerating uncertainty) | |
| •Condensed by moving Stop, Breath, Reflect, and Choose to between-session practice | |
| Session 6: Promoting Positivity Contemplation, physical activity, optimism, relaxation signals, good bad and routine, gratitude letter | •Added information about FOR and physical activity |
| •Incorporated NCCN Survivorship guidelines for physical activity | |
| •Targeted optimism exercise to FOR | |
| •Added gratitude letter to experiences with cancer survivorship | |
| Session 7: Healing States of Mind Loving kindness, problem-solving vs. acceptance, root fear, creativity, empathy | •Targeted loving kindness exercise to self-compassion when feeling afraid of cancer recurrence |
| •Condensed acceptance vs. problem-solving | |
| •Added worksheet on managing controllable vs. uncontrollable cancer-related uncertainties | |
| •Targeted root fear exercise to cancer-related fear | |
| •Targeted creative expression to expressing FOR creatively | |
| Session 8: Humor, Empathy and Staying Resilient Idealized self, humor, energy battery part 2, staying resilient | •Targeted education about humor as a tool for coping with FOR |
| •Targeted review of skills to include plans to apply skills before, during, and after healthcare visits |
Note: Sessions are delivered weekly and last approximately 90 minutes each.
aApplied throughout Sessions 1-8.