Supportive Care in Cancer

, Volume 22, Issue 8, pp 2075–2083

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

  • Diana Christine Maria Seitz
  • Christine Knaevelsrud
  • Gabriele Duran
  • Sabine Waadt
  • Sabine Loos
  • Lutz Goldbeck
Original Article

DOI: 10.1007/s00520-014-2193-4

Cite this article as:
Seitz, D.C.M., Knaevelsrud, C., Duran, G. et al. Support Care Cancer (2014) 22: 2075. doi:10.1007/s00520-014-2193-4

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.

Keywords

Anxiety Cancer Internet-based psychotherapy Long-term survivor Oncology Post-traumatic stress 

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Diana Christine Maria Seitz
    • 1
  • Christine Knaevelsrud
    • 2
  • Gabriele Duran
    • 3
  • Sabine Waadt
    • 3
  • Sabine Loos
    • 1
  • Lutz Goldbeck
    • 1
  1. 1.Department of Child and Adolescent Psychiatry and PsychotherapyUniversity Hospital UlmUlmGermany
  2. 2.Department of Clinical Psychology and PsychotherapyFree University BerlinBerlinGermany
  3. 3.Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der IsarTechnical University MunichMunichGermany

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