PEER is a four-day residential program for adolescents impacted by their own or a relative's cancer, with both psychosocial (acceptance and commitment therapy, self-compassion) and recreational components. This study aimed to determine whether previously observed improvements in quality of life amongst highly distressed participants were mediated by improvements in processes targeted by psychotherapeutic elements of the program (psychological flexibility, mindfulness, self-compassion, peer support, distress). Adolescents attending PEER completed surveys assessing the quality of life and proposed mediator variables at pre-program, post-program and two-month follow-up. Adolescents experiencing high/very high levels of baseline distress (n = 52; 5 patients/survivors, 31 siblings/offspring, 13 bereaved siblings/offspring) were previously identified as experiencing clinically significant improvements in psychosocial well-being; here, mediation analyses explored whether these improvements were associated with improvements in process variables. Findings evidenced improvements in quality of life amongst distressed PEER participants, mediated by increases in psychological flexibility and self-compassion, and reductions in distress. Peer support and mindfulness were not significant mediators. Together, this suggests that the psychosocial benefits of PEER observed for highly distressed adolescents are linked to the specific therapeutic approaches used in the program, rather than being non-specific effects of peer connection or recreation. Findings from this evaluation provide further evidence for the efficacy and mechanisms of the effect of PEER for supporting distressed adolescents impacted by cancer. The study also demonstrates the viability and utility of the therapeutic approaches (acceptance and commitment therapy, self-compassion) used, showing that they have psychosocial benefits for this population.

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什么可以帮助受癌症影响的痛苦的澳大利亚青少年？改进 PEER 计划的机制

PEER 是一项为期四天的住宿计划，面向受自身或亲属癌症影响的青少年，包括社会心理（接受和承诺疗法、自我同情）和娱乐内容。本研究旨在确定先前观察到的极度痛苦参与者生活质量的改善是否是由该计划的心理治疗要素（心理灵活性、正念、自我同情、同伴支持、痛苦）所针对的过程的改善所介导的。参加 PEER 的青少年完成了评估生活质量的调查，并在项目前、项目后和两个月的随访中提出了中介变量。经历高/非常高水平基线痛苦的青少年（n = 52; 5 名患者/幸存者、31 名兄弟姐妹/后代、13 名失去亲人的兄弟姐妹/后代）先前被确定为在社会心理健康方面有临床显着改善；在这里，调解分析探讨了这些改进是否与过程变量的改进有关。调查结果证明，痛苦的 PEER 参与者的生活质量有所改善，这是由心理灵活性和自我同情的增加以及痛苦的减少所介导的。同伴支持和正念不是重要的中介。总之，这表明 PEER 对高度痛苦的青少年观察到的社会心理益处与该计划中使用的特定治疗方法有关，而不是同伴联系或娱乐的非特定影响。该评估的结果为 PEER 支持受癌症影响的痛苦青少年的效果和机制提供了进一步的证据。该研究还证明了所使用的治疗方法（接受和承诺疗法、自我同情）的可行性和实用性，表明它们对该人群具有社会心理益处。