LiveWell: Pilot Feasibility Trial of an Adapted Dialectical Behavioral Therapy Skills Training Protocol in Patients With Metastatic Non-Small Cell Lung Cancer.
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2025-12
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Abstract
BACKGROUND: People living longer with metastatic non-small cell lung cancer (mNSCLC) experience heightened psychological distress and decrements in quality of life. Therefore, we developed LiveWell, an 8-session adapted dialectical behavioral therapy skills training (DBT-ST) protocol delivered one-on-one via telehealth to reduce psychological distress. AIM: To conduct a single-arm pilot trial examining the feasibility and acceptability of LiveWell and explore change in outcome variables. METHODS: Patients receiving systemic therapy for mNSCLC with at least mild distress participated. Outcomes were feasibility (accrual N = 30 in 18 months, > 80% sessions attended, < 25% attrition) and acceptability (> 80% participant satisfaction). Distress (depression and anxiety symptoms; primary outcomes), intolerance of uncertainty, emotion regulation, illness acceptance, symptoms (e.g., fatigue, dyspnea, pain), skill use, and quality of life (secondary outcomes) were assessed at baseline, post-intervention (primary endpoint), and 1-month post-intervention and examined with paired sample t-tests. RESULTS: Thirty participants (Mage = 63 years, 77% female) consented and completed the baseline assessment. LiveWell met feasibility (accrual N = 30 in 8 months, 93% sessions attended, 87% retention at post-intervention) and acceptability (96% satisfaction) benchmarks. Participants demonstrated reductions in distress (depression d = 0.35, anxiety d = 0.22) from baseline to post-treatment. Intolerance of uncertainty (d = 0.71), emotion regulation (d = 0.49), and illness acceptance (d = 0.45) improved. Fatigue and pain remained stable or improved (d's 0.07-0.38). Skill use increased (d = 0.65) and quality of life improved (d = 0.21). Improvements were maintained or enhanced at 1-month follow-up. CONCLUSIONS: LiveWell was feasible and acceptable, and participants demonstrated promising improvement in primary and secondary outcomes. Findings support a larger randomized efficacy trial. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04973436.
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Hyland, Kelly A, Andrada D Neacsiu, Hannah M Fisher, Colleen M Cowperthwait, Natalie Chou, Thomas E Stinchcombe, Kevin C Oeffinger, Laura S Porter, et al. (2025). LiveWell: Pilot Feasibility Trial of an Adapted Dialectical Behavioral Therapy Skills Training Protocol in Patients With Metastatic Non-Small Cell Lung Cancer. Psychooncology, 34(12). p. e70357. 10.1002/pon.70357 Retrieved from https://hdl.handle.net/10161/33783.
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Andrada Delia Neacsiu
I am a clinical psychologist with a primary interest in outpatient interventions for difficulties managing emotional experiences that interfere with well-being. As a clinician, I specialize in Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) for adults who report a variety of mental health problems, including personality, mood, anxiety, eating, trauma, stress-related, adjustment, and impulse control disorders. My approach to psychotherapy includes working collaboratively with my patients to identify their unique life and therapy goals and implementing evidence-based interventions to achieve the identified goals. As an educator, I train clinicians nationally and teach graduate students, psychology and psychiatry residents in in how to effectively apply CBT and DBT in their clinical work. As a researcher, I focus on psychotherapy optimization and neuroscience-informed treatment development for emotion dysregulation. My research keeps me up to date with the latest evidence-based approaches to use in my clinical work, and my work with patients strongly influences the research that I do. Outside of work, I enjoy traveling, gourmet food, nature adventures, and time with friends with family.
Colleen M Cowperthwait
Laura S Porter
My research focuses on developing and evaluating behavioral interventions to help patients and their family members cope with the symptoms and psychological demands associated with chronic and life-limiting illness.
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