Background/Introduction People with advanced progressive illness frequently experience psychological challenges, such as fear of dying, being a burden, and existential distress. Acceptance and Commitment Therapy (ACT) is a mindfulness-based behavioural therapy aimed at improving wellbeing and promoting valued living by cultivating flexible responding to these challenges. There is evidence for its effectiveness across a range of health problems. Evidence in palliative care settings is emerging.

Objectives To synthesise the evidence for Acceptance and Commitment Therapy for people with palliative care needs, their informal caregivers, and staff involved in their care.

Methods A systematic scoping review was undertaken using four databases (Medline, PsychInfo, Embase and AMED), with relevant MeSH terms and key words from January 1999 to February 2022. Three research registries were also searched.

Results 1,636 records were identified, 86 articles underwent full text review and 25 papers were included in the final set. Of these, 14 studies examined people with advanced progressive illness, four were focused on informal caregivers, three on staff and four on bereaved populations. The interventional studies (n=15) showed preliminary evidence for the positive impacts of ACT on anxiety, depression, distress, pain and sleep interference. However, the sample sizes were often small and consequently not all improvements were statistically significant. The majority of the interventions were delivered in person (n=6) and were delivered by a specialist such as a clinical psychologist (n=10). The observational studies (n=10) revealed a positive relationship between acceptance and adjustment to loss, physical function, low levels of stress and burnout and increased valued living.

Conclusion ACT may improve anxiety, depression, sleep, physical symptoms and quality of life for people with advanced progressive illness; and is beneficial for informal caregivers and professionals. Greater methodological rigour is needed to strengthen the evidence base.