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ACT vs CBT in Palliative Care — SCE Palliative Medicine MCQ

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ModeratePsychological & PsychiatricACT vs CBT in Palliative CareSCE Palliative Medicine

A 60-year-old man with advanced lung cancer asks about Acceptance and Commitment Therapy (ACT). How does ACT differ from traditional CBT in the palliative care context?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — ACT emphasises accepting difficult thoughts and feelings rather than challenging or changing them, and committing to valued actions despite suffering—especially useful when cognitive restructuring is limited by unchangeable realities (e.g. terminal illness)

Explanation lettering: D = shown as A · A = shown as C · C = shown as D

In palliative care, patients often face unchangeable psychological realities. Traditional CBT aims to restructure thoughts, which may be unrealistic (e.g. fear of death). ACT instead promotes psychological flexibility by encouraging acceptance of distressing internal experiences and commitment to meaningful actions—a paradigm shift better suited to terminal illness. Distractors: A ignores the difference; B misstates ACT’s non-suppressive stance; C is incorrect—ACT evolves from CBT; D oversimplifies by ignoring ACT’s cognitive (acceptance) component.

Reference: NICE NG193, Rationale and impact (2021) and NHS EMCH Network ACT overview