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Efficacy of an internet-based cognitive-behavioral intervention for long-term survivors of pediatric cancer: a pilot study

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Abstract

Purpose

Long-term survivors of pediatric cancer have an increased risk of post-traumatic stress symptoms (PTSS) and dysfunctional anxiety. However, there is a lack of evidence-based psychotherapy tailored to the needs of this target group. In this single-arm pilot study, an Internet-based psychological intervention (“Onco-STEP”) for adolescent and young adult survivors was developed, and its efficacy in reducing PTSS and anxiety was evaluated.

Methods

Former patients of pediatric cancer older than 15 years manifesting clinically relevant PTSS or anxiety were eligible. The cognitive-behavioral treatment consists of ten writing sessions and comprises two modules: the first aiming to reprocess the traumatic cancer-related experiences and the second aiming to build coping strategies with current cancer-related fears. Treatment was delivered via written messages on a secure Internet platform. Outcomes were assessed by the Post-traumatic Stress Diagnostic Scale, the Hospital Anxiety and Depression Scale, and the Fear of Progression/Relapse Questionnaire.

Results

A total of 20 participants completed the intervention (mean age 27.3 ± 4.8 years at study; 13.8 ± 4.7 years since diagnosis; 70 % female). PTSS, anxiety, and fear of progression/relapse significantly declined at the end of the intervention, with pre–post effect sizes of 0.63, 0.74, and 0.48. In addition, we found a significant decrease in symptoms of depression. Except for the improvement in depression, all effects were sustained 3 months after the end of treatment.

Conclusions

The results show that the intervention is efficacious in reducing symptoms of post-traumatic stress and anxiety. Onco-STEP is a promising new way to treat young adult long-term survivors of pediatric cancer with late psychological effects. Future efforts need to focus on investigating specific evidence of the intervention in a randomized controlled trial.

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Acknowledgments

The study was funded by the Deutsche Krebshilfe e.V. (Grant Number 109358)

Conflict of interest

The authors report no conflict of interest.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075, Ulm, Germany

    Diana Christine Maria Seitz, Sabine Loos & Lutz Goldbeck

  2. Department of Clinical Psychology and Psychotherapy, Free University Berlin, Berlin, Germany

    Christine Knaevelsrud

  3. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany

    Gabriele Duran & Sabine Waadt

Authors
  1. Diana Christine Maria Seitz
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  2. Christine Knaevelsrud
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  3. Gabriele Duran
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  6. Lutz Goldbeck
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Correspondence to Diana Christine Maria Seitz.

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Seitz, D.C.M., Knaevelsrud, C., Duran, G. et al. Efficacy of an internet-based cognitive-behavioral intervention for long-term survivors of pediatric cancer: a pilot study. Support Care Cancer 22, 2075–2083 (2014). https://doi.org/10.1007/s00520-014-2193-4

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  • DOI: https://doi.org/10.1007/s00520-014-2193-4

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