Abstract
BACKGROUND: Breast cancer survivors often experience psychosocial challenges, including fear of cancer recurrence, diminished quality of life, and are less aware of the potential for post-traumatic growth. Life coaching is a strengths-based, goal-directed approach that may promote adjustment and recovery after cancer. AIM: This randomized controlled trial evaluated the effects of a life coaching intervention on post-traumatic growth (PTG), fear of cancer recurrence (FCR), and quality of life (QoL) in breast cancer survivors post-treatment. METHODS: In a three-arm randomized controlled trial at a single site, 90 women with stage I-III breast cancer were randomized to three study arms: (1) group + individual coaching, (2) group coaching only, or (3) control group receiving routine care. Coaching was delivered virtually over 15-18 weeks. The three study outcomes (PTG, FCR, QoL) were assessed at baseline, post-group coaching (T1), end of intervention (T2), and 3-month follow-up (T3). Analyses included generalized estimating equations and analysis of covariance models. RESULTS: Across the three study outcomes, no sustained or broad statistically significant improvements were observed for either experimental arms compared with control. At T2, arm 1 participants reported higher scores on the post-traumatic growth inventory "new possibilities" subscale compared with control (OR = 1.078, 95% CI [1.00, 1.16], p = 0.0382), and arm 2 participants reported lower FCR scores than control (p = 0.0159); however, neither effect was maintained at T3. Significant differences were also observed for three QoL domains (ability to participate in social roles, fatigue, and pain interference). No significant differences were found for the remaining post-traumatic growth inventory subscales or QoL domains. CONCLUSIONS: This first randomized controlled trial of life coaching in cancer survivorship found no sustained improvements in post-traumatic growth, fear of cancer recurrence, or quality of life. Limited short-term benefits suggest the intervention, in its current form, is unlikely to yield lasting psychosocial gains, underscoring the need to refine both content and outcome measures in future research. TRIAL REGISTRATION: Clinical Trial Registry (NCT05020561).