The World Health Organization (WHO) estimates that each year worldwide, “400,000 children and adolescents of 0-19 years old develop cancer“. Although many childhood cancers are now effectively treated—with survival rates approaching 80% in high-income countries —cancer remains a significant predisposing factor for long-term psychological distress and mental disorders . These consequences on mental health stem from multiple sources such as long-term side effects of cancer treatment, disruption of age-appropriate developmental tasks (4), and chronic stressors such as fear of cancer recurrence (FCR), intrusive memories, social isolation, and elevated school absenteeism.
As Dr. Michael Hoyt puts it: “What’s cancer interrupting in the life of young adults? And how is cancer interrupting it?”
In my research, I’m focusing on PBT and ACT and their potential role in pediatric psycho-oncology, mostly in adolescent and young adult (AYA) cancer survivors.
ACT is a well-established third-wave CBT model with documented effectiveness across behavioral medicine and psycho-oncology. Its theoretical model — organized around six core therapeutic processes (acceptance, cognitive defusion, mindfulness, self-as-context, clarifying values, and committed actions) — is particularly suited to populations confronting life-threatening illness, as it addresses existential distress, unavoidable suffering, and value-based engagement rather than symptom elimination. Rather than attempting to eliminate difficult thoughts and emotions, ACT emphasizes changing how individuals relate to them. This enables patients to experience unavoidable distress while continuing to take actions aligned with their personal values. Crucially for the populations under review, ACT’s process-based model maps directly onto key psychosocial challenges of young people and their parents: acceptance and defusion may address FCR, intrusive memories, serving as emotion regulation strategies; self-as-context supports identity reconstruction beyond the cancer experience; and values-based committed action may reduce school avoidance and increase class attendance. Together, these processes strengthen psychological flexibility, which is associated with reduced psychological symptoms and greater well-being across diverse clinical presentations .