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An examination of depression, anxiety, and fear of recurrence among cancer survivors who participated in a virtual cognitive behavioral therapy (CBT)-based telephone coaching program

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Abstract

Background

Depression, anxiety, and fear of recurrence (FOR) are prevalent among cancer survivors, and it is recommended that they have access to supportive services and resources to address psychosocial needs during follow-up care. This study examined the impact of a virtual cognitive behavioral therapy (CBT)-based telephone coaching program (BounceBack®) on depression, anxiety, and FOR.

Method

Through the After Cancer Treatment Transition (ACTT) clinic at the Women’s College Hospital (Toronto, Canada), eligible participants were identified, consented, and referred to the BounceBack® program. Program participation involved completion of self-selected online workbooks and support from trained telephone coaches. Measures of depression (PHQ-9), anxiety (GAD-7), and FOR (fear of cancer recurrence inventory, FCRI) were collected at pre-intervention (baseline) and post-intervention (6-month and 12-month time points). For each psychosocial measure, paired t-tests compared mean scores between study time points. Participant experiences and perceptions were collected through a survey.

Results

Measures of depression and anxiety significantly improved among participants from pre-intervention to post-intervention. Scores for PHQ-9 and GAD-7 decreased from moderate to mild levels. Measure of FOR also significantly improved, while FCRI sub-scale scores significantly improved for 5 of the 7 factors that characterize FOR (triggers, severity, psychological distress, functional impairment, insight). Participants rated the intervention a mean score of 7 (out of 10), indicating a moderate level of satisfaction and usefulness.

Conclusion

This study suggested that a virtual CBT-based telephone coaching program can be an effective approach to managing depression, anxiety, and fear of recurrence in cancer survivors.

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Data availability

Data and material availability may be provided by research team upon request.

Code availability

There was no coding of data for quantitative analysis. Coding for qualitative analysis (i.e., themes, sub-themes) is already available in Supplemental Table 1.

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Acknowledgements

This study was supported by The Peter Gilgan Centre for Women’s Cancers at Women’s College Hospital, in partnership with the Canadian Cancer Society. This study was also in collaboration with the Canadian Mental Health Association (Ontario and York and South Simcoe Divisions, Ontario, Canada).

Author information

Authors and Affiliations

  1. Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, ON, Toronto, Canada

    Patricia Nguyen, Ruth Heisey, Elaine Goulbourne, Rumaisa Khan & Emma Rinaldo

  2. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Ruth Heisey

  3. Canadian Mental Health Association Ontario, Toronto, ON, Canada

    Camille Quenneville & Helen Chagigiorgis

  4. Canadian Mental Health Association York Region and South Simcoe Branch, Newmarket, ON, Canada

    Rebecca Shields

  5. After Cancer Treatment Transition Program, Women’s College Hospital, Toronto, ON, Canada

    Carol Townsley

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  1. Patricia Nguyen
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Contributions

Patricia Nguyen, Ruth Heisey, Camille Quenneville, Elaine Goulbourne, Rebecca Shields, and Carol Townsley contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Patricia Nguyen, Carol Townsley, Ruth Heisey, and Rumaisa Khan. Clinical expertise was provided by Ruth Heisey, Carol Townsley, Emma Rinaldo, and Helen Chagigiorgis. The first draft of the manuscript was written by Patricia Nguyen, and all authors reviewed and provided feedback.

Corresponding author

Correspondence to Patricia Nguyen.

Ethics declarations

Ethics approval

The study was approved by the Research Ethics Board in the Women’s College Research Institute, Women’s College Hospital, Toronto, Canada, with REB #2019-0046E.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Consent to publish is not applicable. No individual data is presented in the manuscript.

Competing interests

The authors declare no competing interests.

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Nguyen, P., Heisey, R., Quenneville, C. et al. An examination of depression, anxiety, and fear of recurrence among cancer survivors who participated in a virtual cognitive behavioral therapy (CBT)-based telephone coaching program. Support Care Cancer 30, 7323–7332 (2022). https://doi.org/10.1007/s00520-022-07148-6

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