TY - JOUR
T1 - Making Internet-delivered cognitive behaviour therapy scalable for cancer survivors
T2 - a randomized non-inferiority trial of self-guided and technician-guided therapy
AU - Dirkse, D.
AU - Hadjistavropoulos, H. D.
AU - Alberts, N. A.
AU - Karin, E.
AU - Schneider, L. H.
AU - Titov, N.
AU - Dear, B. F.
PY - 2020/4
Y1 - 2020/4
N2 - Purpose: To compare the effectiveness and acceptability of two low-intensity methods of offering a transdiagnostic Internet-delivered cognitive behaviour therapy (ICBT) intervention for treating symptoms of anxiety and depression among cancer survivors. Methods: Cancer survivors with symptoms of anxiety or depression (n = 86) were randomly assigned to receive a transdiagnostic ICBT programme (Wellbeing After Cancer) that was either guided by a technician (n = 42) or self-guided (n = 44). Measures of anxiety, depression, fear of cancer recurrence, and quality of life were completed at pre-treatment, post-treatment, and 4 weeks following treatment completion. Results: Large within-group effect sizes were observed on measures of depression, anxiety, and mental health-related quality of life (d range, 0.98–1.86) at post-treatment. Medium effects were found for reductions in fear of cancer recurrence (d range, 0.65–0.78). Non-inferiority was established for the primary outcome measures of anxiety and depression. All participants reported high satisfaction ratings of the programme; however, technician-guided participants were slightly more satisfied with their level of support (d = 0.57, p =.014). Conclusions: The Wellbeing After Cancer Course was associated with improved levels of anxiety, depression, fear of cancer recurrence, and quality of life, regardless of how ICBT was offered. Implications for Cancer Survivors: ICBT is emerging as an accessible and effective treatment for depression, anxiety, and fear of cancer recurrence in cancer survivors. The success of non-therapist-guided options increases the potential scalability of ICBT, which is particularly valuable for cancer survivors from rural areas who have less access to mental health services.
AB - Purpose: To compare the effectiveness and acceptability of two low-intensity methods of offering a transdiagnostic Internet-delivered cognitive behaviour therapy (ICBT) intervention for treating symptoms of anxiety and depression among cancer survivors. Methods: Cancer survivors with symptoms of anxiety or depression (n = 86) were randomly assigned to receive a transdiagnostic ICBT programme (Wellbeing After Cancer) that was either guided by a technician (n = 42) or self-guided (n = 44). Measures of anxiety, depression, fear of cancer recurrence, and quality of life were completed at pre-treatment, post-treatment, and 4 weeks following treatment completion. Results: Large within-group effect sizes were observed on measures of depression, anxiety, and mental health-related quality of life (d range, 0.98–1.86) at post-treatment. Medium effects were found for reductions in fear of cancer recurrence (d range, 0.65–0.78). Non-inferiority was established for the primary outcome measures of anxiety and depression. All participants reported high satisfaction ratings of the programme; however, technician-guided participants were slightly more satisfied with their level of support (d = 0.57, p =.014). Conclusions: The Wellbeing After Cancer Course was associated with improved levels of anxiety, depression, fear of cancer recurrence, and quality of life, regardless of how ICBT was offered. Implications for Cancer Survivors: ICBT is emerging as an accessible and effective treatment for depression, anxiety, and fear of cancer recurrence in cancer survivors. The success of non-therapist-guided options increases the potential scalability of ICBT, which is particularly valuable for cancer survivors from rural areas who have less access to mental health services.
KW - internet
KW - cognitive behaviour therapy
KW - anxiety
KW - depression
KW - cancer survivor
KW - randomized trial
UR - http://www.scopus.com/inward/record.url?scp=85077018036&partnerID=8YFLogxK
U2 - 10.1007/s11764-019-00810-9
DO - 10.1007/s11764-019-00810-9
M3 - Article
C2 - 31853727
AN - SCOPUS:85077018036
SN - 1932-2259
VL - 14
SP - 211
EP - 225
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
IS - 2
ER -