Positive psychological therapy has been found to be effective in psychological health in the broader cancer patient population. However, specific evidence regarding its effectiveness for adolescent and young adult (AYA) cancer patients remains limited. More research is needed to determine the optimal approaches for alleviating distress in this particular group. We evaluated the efficacy of character strength-based cognitive-behavioral therapy (CS-CBT) versus cognitive-behavioral therapy (CBT) for distress in AYA patients with cancer. In a randomized controlled three-arm trial, cancer patients aged 15-39 years were assigned to one of three groups using a random number table to ensure equal group sizes: (1) CS-CBT, which incorporated specific exercises focused on identifying and utilizing character strengths within the CBT framework; (2) CBT; or (3) control group. The primary outcome was improvement in patients’ overall mental health on the Distress Thermometer and the Hospital Anxiety and Depression Scale 3 months after assignment to the groups. Analyses used generalized estimating equations. A total of 162 AYAs were randomly and equally assigned to three groups. Improvements in primary outcomes were significantly greater after CS-CBT than after CBT, and no significant differences were found between the CBT and control group. Among all primary and secondary outcomes, the only non-significant difference found was in quality of life with CS-CBT compared to CBT. AYA cancer patients rated their overall mental health and sense of thriving as more improved after CS-CBT than after CBT. However, quality-of-life indicators supported equal intervention effects in both groups. These findings support the effectiveness of the use of CS-CBT intervention in reducing distress and improving thriving.

积极的心理治疗已被发现对更广泛的癌症患者群体的心理健康有效。然而，关于其对青少年和年轻成人 (AYA) 癌症患者有效性的具体证据仍然有限。需要更多的研究来确定减轻这一特定群体痛苦的最佳方法。我们评估了基于性格强度的认知行为疗法 (CS-CBT) 与认知行为疗法 (CBT) 对 AYA 癌症患者痛苦的疗效。在一项随机对照三臂试验中，年龄 15-39 岁的癌症患者使用随机数字表被分配到三组之一，以确保组大小相等：(1) CS-CBT，其中包含专注于识别和利用的特定练习CBT 框架内的性格优势； (2) 认知行为治疗；或（3）对照组。主要结果是分配到各组后 3 个月，患者在痛苦温度计和医院焦虑和抑郁量表上的整体心理健康状况有所改善。使用广义估计方程进行分析。总共 162 名 AYA 被随机平均分配到三组。 CS-CBT 后主要结局的改善明显大于 CBT 后，并且 CBT 和对照组之间没有发现显着差异。在所有主要和次要结果中，发现的唯一非显着差异是 CS-CBT 与 CBT 相比的生活质量。 AYA 癌症患者认为 CS-CBT 后的整体心理健康状况和欣欣向荣感比 CBT 后有更大改善。然而，生活质量指标支持两组的干预效果相同。 这些发现支持使用 CS-CBT 干预措施在减少痛苦和改善成长方面的有效性。