Facilitating Adaptive Coping with Fear of Recurrence among Breast Cancer Survivors

Inclusion Criteria

• Patient is >= 18 years old
• Patient has been diagnosed with stage I-IIIA breast cancer without evidence of distant disease at time of study entry
• Patient has completed surgery, radiation therapy, chemotherapy, and/or biologic therapy =< 5 years prior (ongoing endocrine therapy is allowed)
• Patient has clinically significant FCR (FCRI-Short Form score >= 13 at screening
• Patient is willing to be randomized into any of the 3 arms of the trial and attend a 5-week videoconference group if randomly assigned to ACT or CBT
• Patient is able to speak and read English

Exclusion Criteria

• Patient has a previous cancer diagnosis besides breast (non-melanoma skin cancer is allowed)
• Patient is currently participating in ACT, CBT, formal mindfulness meditation training, or the “Mobile Device CBT for Chemotherapy-Related Cognitive Dysfunction: A Multi-Center Randomized Controlled Trial” (PI McDonald), the “Thinking and Living With Cancer” study (local PI: Andrew Saykin), or any other research study that has the potential to skew results of this study or the study in which the person is participating
• Patient has co-morbidities, medications, or deficits that would impair participation in ACT or CBT groups, including: * History of stroke, encephalitis, traumatic brain injury/surgery, Alzheimer’s disease, or other dementia; * Severe depressive symptoms (Patient Health Questionnaire [PHQ]-8 score >= 20 at screening); * Active substance abuse or uncontrolled bipolar disorder, psychosis, or schizophrenia; * Obvious hearing and/or communicative disability.
• Patient has opted out of pre-screening for research studies (sometimes noted in the EMR)