Mindfulness-integrated Cognitive Behavior Therapy reduces pain and psychological distress, and improves equanimity, hope and post-traumatic growth during breast cancer treatment

Background Chemotherapy is associated with many side effects, including pain and psychological discomforts, which affect patients' physical and psychological health. Objectives. The objective of this study was to evaluate the effectiveness of a shortened version of Mindfulness-integrated Cognitive Behavior Therapy (MiCBT) in managing pain and psychological distress (including depression, anxiety, and stress), improving equanimity, hope, and post-traumatic growth in patients with Stage I-III breast cancer undergoing chemotherapy. Methods A total of 62 women were randomly assigned to either an intervention group (n=21) or a treatment-as-usual (TAU) control group (n=21), with 9 women lost to follow-up. All participants completed a battery of assessments for pain, emotional distress, hope, equanimity, and post-traumatic growth before and after the intervention, as well as at the 2-month follow-up. The intervention consisted of a short (4-week) version of the MiCBT program, which involved progressive muscle relaxation, mindfulness of breath, body scanning, and the mindfulness-based interoceptive exposure task (MIET) for pain. Results The MiCBT program was conducted over four consecutive weeks with an emphasis on the mindfulness-based interoceptive exposure task (MIET) for pain. Compared with the TAU group, at post-treatment, the MiCBT group experienced larger and significant reductions in pain, psychological distress, depression, anxiety, and stress, and large improvements in equanimity and hope. These differences remained significant at 2-month follow-up. Conclusion This study provides preliminary evidence that a four-week MiCBT intervention can improve the daily experiences of women with BC undergoing chemotherapy. Further research using larger samples and active control is needed to determine the generalizability of the results. Trial registration This study was registered in the Iranian Clinical Trial Registry (registry ID: IRCT20220903055860N1, registration date: 2022-09-29).