Stress Management and Resilience Training (SMART) program to decrease stress and enhance resilience among breast cancer survivors: a pilot randomized clinical trial

Clin Breast Cancer. 2011 Dec;11(6):364-8. doi: 10.1016/j.clbc.2011.06.008. Epub 2011 Aug 10.


This randomized controlled trial assessed the effect of a SMART (Stress Management and Resiliency Training) program among 25 women diagnosed with breast cancer. Resilience, perceived stress, anxiety, and quality of life improved at 12 weeks in the active but not the control arm. A brief training in the SMART program can enhance resilience and quality of life and decrease stress and anxiety.

Introduction: Patients with breast cancer experience stress and anxiety related to their diagnosis, with resulting lower quality of life. The purpose of this study was to assess the effect of a SMART (Stress Management and Resiliency Training) program for increasing resiliency and for decreasing stress and anxiety among mentors who themselves were previously diagnosed with breast cancer.

Materials and methods: The program consisted of two 90-minute group training sessions, a brief individual session, and 3 follow-up telephone calls. Twenty-four mentors at Mayo Clinic in Rochester, Minnesota, were randomized in a single-blind, wait-list controlled clinical trial to either the SMART intervention or a control group for 12 weeks. Primary outcome measures assessed at baseline and at week 12 included the Connor Davidson Resilience Scale, Perceived Stress Scale, Smith Anxiety Scale, and Linear Analog Self Assessment Scale.

Results: Twenty patients completed the study. A statistically significant improvement in resilience, perceived stress, anxiety, and overall quality of life at 12 weeks, compared with baseline was observed in the study arm. No significant difference in any of these measures was noted in the control group.

Conclusion: This study demonstrates that a brief, predominantly group-based resilience training intervention is feasible in patients with previous breast cancer; also, it may be efficacious.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Aged
  • Breast Neoplasms / pathology
  • Breast Neoplasms / psychology*
  • Carcinoma, Ductal, Breast / pathology
  • Carcinoma, Ductal, Breast / psychology
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Intraductal, Noninfiltrating / psychology
  • Carcinoma, Lobular / pathology
  • Carcinoma, Lobular / psychology
  • Counseling*
  • Female
  • Health Education*
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Pilot Projects
  • Quality of Life*
  • Stress, Psychological / therapy*
  • Treatment Outcome