31 Outcomes of an ACT-Based Group Protocol on Neuropsychological Late Effects in Survivors of Childhood Cancer

Abstract

Objective:Attention of the research community on childhood cancer has grown exponentially over the last 5 decades (Robinson & Hudson, 2014). With research attention growing rapidly, cure rates have increased just as dramatically, with survivorship well over 80% (Ward, et al., 2014). With survivorship on the rise, research has turned to the examination of late effects in survivors of childhood cancer, especially neuropsychological late effects (Krull, et al., 2018). Late effects, functional impairment, and the awareness of one’s own impairment can create several lasting issues in a survivor’s life (Oeffinger, et al., 2010). The objective of this study is to explore the feasibility and functionality of a group intervention for this population.Participants and Methods:Participants were recruited from a pediatric cancer institute in southern California. To be considered for inclusion, participants must have completed curative treatment for childhood cancer, not be currently undergoing treatment for childhood cancer, be free of any severe and persistent mental illnesses, and have access to a stable internet connection (for Zoom sessions). This study examined the impact of an Acceptance and Commitment Therapy (ACT)-based group intervention protocol on survivors of childhood cancer. Specifically, this study explored a strategy to identify early neuropsychological late effects and a strategy to improve these impacts. The group intervention was conducted via Zoom (www.zoom.us) which provided an opportunity to continue to provide this service in the wake of COVID-19. Data was collected at baseline and at the completion of the group intervention. This data focused on the functional and perceived impacts of neuropsychological sequelae in these participants, as well as the changes as related to the group intervention.Results:Data did not show any significant changes from baseline to follow-up in this population. The lack of significance was likely due to a severely truncated sample size. Despite the lack of significant findings, data appears to trend negatively. Although these findings do not provide conclusive evidence for this ACT-based group as an intervention for neuropsychological late effects in survivors of childhood cancer, the data suggested some interesting trends which will be explored further in this presentation.Conclusions:The results of this study help to further explore the importance of attention to neuropsychological symptoms and issues in survivors of childhood cancer, especially within the first few years following the completion of treatment. As survivorship continues to increase, it will be of utmost importance to continue to examine the impact of neuropsychological late effects and how the field of neuropsychology can best serve this population. This study was severely limited by a small sample size, a single clinician providing the protocol, and a truncated timeline. Further research will examine the impact of this study protocol in a larger sample size, which will likely increase the ability to reject the null hypothesis. In addition, future research must also be conducted to better explore strategies of early and consistent neuropsychological intervention in this population.