# Dialectical Behavioral Therapy Skills Training for Metastatic Lung Cancer Patients

> **NIH NIH F32** · DUKE UNIVERSITY · 2021 · $65,610

## Abstract

Metastatic lung cancer patients experience significantly greater psychological distress (i.e., depression,
anxiety) compared to other cancers. Psychological distress is as a prognostic indicator for worse clinical
outcomes and poorer overall survival in cancer patients. Due to their historically poor prognosis, patients with
metastatic lung cancer are often excluded from psychosocial intervention protocols. Existing interventions do
not address factors that contribute to elevated psychological distress in these patients, including managing
high physical symptom burden (fatigue, dyspnea, pain), regulating challenging emotions (shame, guilt, fear),
and tolerating uncertainty about the future. Dialectical behavioral therapy (DBT) is a transdiagnostic, evidence-
based psychotherapy that teaches participants a core set of behavioral skills (distress tolerance, emotion
regulation, mindfulness, interpersonal effectiveness) to cope more effectively with emotional and physical
symptoms. DBT skills training has been adapted for a variety of clinical populations and has demonstrated
efficacy in reducing psychological distress. To date, DBT skills training has not been evaluated in patients with
metastatic lung cancer, who stand to benefit immensely. We anticipate DBT skills training will need to be
adapted to increase acceptability and relevance in patients with metastatic lung cancer, including 1) delivery,
2) dose, and 3) materials. The proposed study seeks to adapt and pilot test DBT skills training for patients with
metastatic lung cancer using the ADAPT-ITT framework. Participants will be metastatic lung cancer patients
who score >3 on the NCCN distress thermometer. Phase I aims to use focus groups and interviews with key
stakeholders (metastatic lung cancer patients (N=20), thoracic oncology providers (N=6), clinicians with
expertise in survivorship and behavioral symptom management (N=6)) to determine if and how DBT skills
training must be modified for implementation with metastatic lung cancer patients. Adapted material will be
reviewed by topical experts in DBT and implementation science. It is hypothesized that these activities will
produce a manualized, adapted DBT skills training protocol for metastatic lung cancer patients (DBT-MLC).
Phase II aims to pilot test DBT-MLC to assess feasibility, acceptability, and examine pre-to-post intervention
outcomes. It is hypothesized that participants will report improvement on primary (psychological distress, i.e.,
depression and anxiety) and secondary outcome measures (fatigue, dyspnea, pain, emotion regulation,
tolerance of uncertainty, DBT coping skill use). This project meets the National Cancer Institute's priority
research area of cancer survivorship, and involves innovative adaptation of an evidence-based intervention for
an underserved cancer population. Positive findings would rapidly inform the next step of research, conducting
a phase 2b randomized efficacy trial comparing DBT-MLC to a control c...

## Key facts

- **NIH application ID:** 10314204
- **Project number:** 1F32CA265058-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Kelly Alexandra Hyland
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $65,610
- **Award type:** 1
- **Project period:** 2021-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10314204

## Citation

> US National Institutes of Health, RePORTER application 10314204, Dialectical Behavioral Therapy Skills Training for Metastatic Lung Cancer Patients (1F32CA265058-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10314204. Licensed CC0.

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