Table 2 Modules, key components and example exercises of ‘Hold on, for each other’

1. Coping with your emotions

Acceptance

How I put on a brave face?: Description: We ask partners to write down emotional situations they have experienced, how they felt at that moment the situation occurred and how they coped with it. Aim: To help partners to be aware of their own emotions and their coping mechanisms. Are they regularly putting on a brave face and are they suppressing their emotions?

Self-compassion/Mindulness

2. Your resilience-plan – how can you keep going?

Acceptance

How much do you demand of yourself?: Description: We ask partners to write down how many hours they work, sleep, and have leisure time each week. Aim: To show partners how much they demand of themselves and if their planning is realistic.

Self-compassion/Mindfulness

3. My mind works overtime

Cognitive defusion

Worry Box: Description: In this exercise we ask partners to write down their thoughts, worries and fears on a piece of paper and put each paper in a box. After that they have to close the box and put it away. Later they can throw the box away or they can open it once in a month and read the worries again. Aim: To show that worries are often not based on firm grounds. The worry-box can help to put worries in perspective and it can show that ruminating is often useless.

Self-compassion/Mindfulness

4. What is now really important?

Values

Values in your relationship: Description: We asked partners to write down those things in their relationship that they value the most. Aim: To make them aware of things that are not congruent with their values. Are there things that should be different? Is it worth it to invest in the relationship? What can they do to come closer to their values.

Self-compassion/Mindfulness

5. Afraid, tired and moments of joy

Committed action

Celebrate your relationship: Description: we asked partners to choose activities (e.g. to write a love letter, to have dinner at their favourite restaurant). Aim: To make them aware of how precious their relationship is and how to live in accordance with their values.

Self-compassion/Mindfulness

6. The art of communication

Communicating about what really matters

What would you like to talk about?: Description: we ask partners to write down topics they have discussed lately with their partner, if there are topics that haven’t been discussed yet, and -if so- why these topics haven’t been discussed yet. Aim: To stimulate partners to communicate about the things that really matter.

Self-compassion/ Mindfulness

7. Moving on with life (optional)

Acceptance, cognitive defusion, values

Increase your hope: Description: We ask partners to imagine the situation that their partner is cancer free for almost a year, and that he/she is feeling alright. They -as a partner- have done everything possible to cope with the situation, they have accepted it and they are moving on with life. We ask them to imagine how life could be under these conditions. Aim: To show them that it sometimes can be helpful to create some distance and to have a closer look at their situation from a different point of view.

Self-compassion/Mindfulness

8. A good last period (optional)

Acceptance, communicating about what really matters, committed action

Beautiful memories: Description: We ask partners to think about (alone or with their spouse) what they can do to produce new memories (e.g. think about things you want to experience together, trips or activities you want to make). Aim: In this exercise a lot of aspects come together. To accept the development of the disease, to talk about what really matters at the moment, and to commit to values and live in accordance to them.

Self-compassion/Mindfulness