BACKGROUND: Managing Cancer and Living Meaningfully (CALM) is a brief, evidence-based psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study has systematically examined CALM in adults with brain metastases, despite the well-documented incidence of distress in this growing population. The primary aim of this trial was to assess the feasibility and acceptability of CALM in adults with brain metastases. METHODS: Patients with brain metastases ( RESULTS: Of the 13 enrolled participants, 11 completed baseline assessments and initiated treatment: 73% female, CONCLUSIONS: CALM is feasible and acceptable and may improve psychological distress in adults with brain metastases. The findings of this study align with our previous trial of patients with malignant glioma and support a future National Institute of Health Obesity Related Behavioral Intervention Trials phase II randomized pilot trial of CALM in neuro-oncology. TRIAL REGISTRATION NUMBER: NCT05087095 registered on March 23, 2022.