Objective: To assess the effectiveness of cognitive-behavior (CB) group intervention versus relaxation and guided imagery (RGI) group training. Method: A total of 114 early-stage breast cancer patients were randomly assigned to CB, RGI, or control groups, and instruments were completed at pre- and postintervention and 4 months later. Results: Psychological distress was significantly reduced in both intervention groups compared to the control group. The RGI group was more effective in reducing levels of fatigue and sleep difficulties, whereas the CB group was more effective in reducing external health locus of control. Internal health locus of control did not significantly change. Adherence to self-practice at home was significantly associated with reduction in psychological and physical symptoms. Conclusions: The study supports the use of both CB and RGI models for reducing psychological distress in breast cancer patients. RGI showed advantages in reducing fatigue and improving sleep quality, whereas CB better reduced external health locus of control perceptions. (Contains 4 tables.)