Table 3 M-ACT Content Summary

Group Session 1

How do we Navigate?

Group expectations & ground rules,

Introduce Choice Point, Introduce Advance Care Planning (ACP)

Values, Valued Action, Experiential Approach/Avoidance

Online Module 1

Towards and Away

Tailor Choice Point to the individual participant, Identify personal Toward and Away moves and their impact

Values, Valued Action, Experiential Approach/Avoidance

Group Session 2

Passengers: An Introduction

Brief present-awareness meditation, Debrief online module 1, Introduce Passengers on the Bus metaphor, Create and share personal Passengers cards, Introduce an ACP step and encourage engagement

Mindfulness, Acceptance, Defusion

Online Module 2

Growing Values

Select and learn how to appoint a healthcare proxy based on personal values and small committed actions

Acceptance, Values, Committed Action

Group Session 3

Practice with Passengers

Brief present-awareness meditation, Debrief Online Module 2, Introduce defusion strategies, Do eyes-closed acceptance exercise, Experientially act out Passengers on the Bus in breakout rooms

All Hexaflex Processes

(Mindfulness, Acceptance, Defusion, Self-as-Context, Values, Committed Action)

Online Module 3

Driving Your Bus

Apply the Passengers metaphor to a personally challenging situation with cancer, Identify valued direction/goal and passengers that serve as barriers, Practice acceptance and defusion skills for approaching the thoughts and feelings that the Passenger triggers

All Hexaflex Processes

Group Session 4

Practice with Passengers 2

Brief present-awareness meditation, Debrief Online Module 3, Eyes-closed exercise to identify and connect with a wise/kind passenger, Experientially act out Passengers on the Bus in online breakout rooms

All Hexaflex Processes

Group Session 5

Looking Back, Looking Ahead

Brief present-awareness meditation, Reflect and review content/skills learned in M-ACT, Coach self to use skills in future via writing letter to self (mailed 3 weeks later), Identify skills to continue using, Do lovingkindness meditation

All Hexaflex Processes

Group Booster Session

Reconnect

Brief present-awareness meditation, Check-in, Review and troubleshoot use of M-ACT skills in daily life, Commit to ‘next best move’ in ACP/cancer

All Hexaflex Processes

Brief Online Check-Ins

Check-In 1

Choice Point

Identify personal Toward moves done that day, Celebrate them, link Toward moves to values, Set new small valued goal for today or next day

Values, Committed Action, Self-as-Context

Check-In 2

Skills

Identify values, Acknowledge Passengers in daily life, Practice brief interactive acceptance and defusion skills (choose from a list of each)

Values, Mindfulness, Acceptance, Defusion