Posted from archive: 10.01.2013 | by AMRA


Carlson el al. [Journal of Clinical Oncology] studied a large sample (N=271) of distressed breast cancer survivors who were randomly assigned to one of three treatment conditions: (1) Mindfulness-Based Cancer Recovery (MBCR), (2) Supportive-Expressive Group Therapy (SET) or (3) one-day didactic stress management control (SMS).

Participants were survivors of Stage I-III breast cancer who were no longer in the active phase of treatment and who reported moderate or higher levels of distress but who were free from severe mental illness. MBCR and SET are both empirically validated treatments for psychological distress in breast cancer survivors, and this study is the first head-to-head comparison of their efficacy. Outcome measures included quality of life, social support, and stress-related symptomatology, as well as salivary cortisol measured at regular intervals four times a day over the course of three days both prior to and after intervention.

MBCR and SET participants both maintained their initial steep diurnal cortisol slope after treatment (a desirable stress response), whereas SMS controls showed a flattening in their slope (a dysregulated stress response). These results suggest that MBCR and SET both exert a protective effect against stress-related biological disruption. MBCR participants showed a significantly greater reduction in self-reported stress symptoms than either SET or SMS participants, and a significantly greater improvement in quality of life than SMS participants.

The MBCR group also showed a significantly greater improvement in perceived social support than SET participants, which was a surprise given that SET emphasizes social support. The authors interpret the findings as evidence for MBCR’s superiority as a treatment for psychological distress in breast cancer survivors.


Carlson, L. E., Doll, R., Stephen, J., Faris, P., Tamagawa, R., Drysdale, E., & Speca, M. (2013). Randomized controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). Journal of Clinical Oncology, 31(25):3119-26. [PMID: 23918953]

[Link to abstract]