Comparison of the Effectiveness of Compassion-Focused Therapy and Existential Therapy on Death Anxiety and Illness Acceptance in Patients with Cancer in Remission

Mona Soleiman Heshmat; Iman  Shahbazi; Mahboubeh  Emamgholitabar Darzi; Delara  Abdi; Fatemeh  Hooshmand; Maryam  Shamsi Sayar

Authors

Mona Soleiman Heshmat MA, Department of School Counseling, Ka.C., Islamic Azad University, Alborz, Iran https://orcid.org/0009-0002-1657-6138
Iman Shahbazi MA, Department of Clinical Psychology, Sar.C., Islamic Azad University, Iran Author https://orcid.org/0009-0007-8364-9030
Mahboubeh Emamgholitabar Darzi MA, Department of Clinical Psychology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran Author https://orcid.org/0009-0007-7478-8805
Delara Abdi MA, Department of Psychology, Ka.C., Islamic Azad University, Alborz, Iran Author https://orcid.org/0009-0004-3171-2083
Fatemeh Hooshmand MA, Department of Clinical Psychology, II.C., Islamic Azad University, Ilam, Iran Author https://orcid.org/0009-0000-3469-6630
Maryam Shamsi Sayar MA, Department of Clinical Psychology, Hormozgan Branch, University of Science and Research, Hormozgan, Iran Author https://orcid.org/0009-0001-9384-0839

Keywords:

Compassion-Focused Therapy, Existential Therapy, Death Anxiety, Illness Acceptance, Cancer, Remission

Abstract

Purpose: This study aimed to compare the effectiveness of Compassion-Focused Therapy and Existential Therapy in reducing death anxiety and increasing illness acceptance among patients with cancer in remission.

Methods and Materials: This applied study used a quasi-experimental pretest-posttest-follow-up design with a control group. The statistical population consisted of patients with common cancers in remission who referred to hospitals in Tehran during 2025–2026. Using purposive sampling, 45 eligible participants were selected and randomly assigned to Compassion-Focused Therapy, Existential Therapy, and control groups, with 15 participants in each group. Both intervention groups received eight 90-minute weekly sessions, while the control group received no psychological intervention. Data were collected using the Templer Death Anxiety Scale and the Acceptance of Illness Scale. The data were analyzed in SPSS version 26 using repeated-measures analysis of variance and Bonferroni-adjusted post hoc comparisons at a significance level of 0.05.

Findings: Repeated-measures analysis of variance showed significant effects of time, group, and time-by-group interaction for death anxiety and illness acceptance (p < 0.001). Bonferroni comparisons indicated that both Compassion-Focused Therapy and Existential Therapy significantly reduced death anxiety and increased illness acceptance compared with the control group (p < 0.001). Compassion-Focused Therapy produced a significantly greater reduction in death anxiety than Existential Therapy (MD = 1.79, SE = 0.41, p < 0.001), whereas Existential Therapy produced a significantly greater increase in illness acceptance than Compassion-Focused Therapy (MD = 2.30, SE = 0.46, p < 0.001). The improvements were maintained at follow-up.

Conclusion: Both Compassion-Focused Therapy and Existential Therapy were effective in improving psychological adjustment among patients with cancer in remission; however, Compassion-Focused Therapy was more effective in reducing death anxiety, whereas Existential Therapy was more effective in increasing illness acceptance.

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