Advertisement

Supportive Care in Cancer

, Volume 25, Issue 7, pp 2129–2136 | Cite as

Acceptability of an internet cognitive behavioural therapy program for people with early-stage cancer and cancer survivors with depression and/or anxiety: thematic findings from focus groups

  • A. Karageorge
  • M. J. MurphyEmail author
  • J. M. Newby
  • L. Kirsten
  • G. Andrews
  • K. Allison
  • S. Loughnan
  • M. Price
  • J. Shaw
  • H. Shepherd
  • J. Smith
  • P. Butow
Original Article

Abstract

Purpose

We developed an eight-lesson internet-delivered CBT (iCBT) program targeting anxiety and depression in early-stage cancer and cancer survivors. To explore the acceptability of the program, we showed volunteers the first two lessons and asked for their views.

Methods

Focus groups (n = 3) and individual interviews (n = 5) were undertaken with 15 participants (11 survivors) with mainly breast (11 of the 15) cancer, who had reviewed intervention materials. Participants were asked to consider the acceptability of the iCBT program content and implementation design (timing, duration). Semi-structured questions guided discussion. Thematic analysis was conducted of participant reactions to the acceptability and/or suitability of materials created for use in a psychological intervention. We took a data-driven (inductive) approach to semantic theme development across the data set.

Results

Participants reported high acceptability of the internet delivery format, good engagement and user-friendly material. Participants were broadly supportive of combining depression and anxiety iCBT resources for early-stage cancer patients and survivors. Participants further indicated that a separate course would be needed to address the needs of patients with advanced stage disease.

Conclusions

Participants welcomed the general development of an internet-delivered CBT intervention program to treat patients with clinical depression and/or anxiety. Furthermore, the sessions reviewed were highly acceptable to all participants. Study findings informed researchers on the development of iCBT resources for the cancer community.

Keywords

Cancer Depression Anxiety Cognitive behavioural therapy (CBT) Qualitative Acceptability 

Notes

Acknowledgements

The iCanADAPT Early program was developed as part of the Anxiety and Depression Pathway (ADAPT) Program, led by the Psycho-oncology Cooperative Research Group (PoCoG). Members of the ADAPT Program Group have contributed to ADAPT activities and resources. The authors would also like to thank the consumer representatives (JCAG members) who reviewed the material.

Funding for the Anxiety and Depression Pathway (ADAPT) Program was provided by a Cancer Institute NSW Translational Program Grant (ID 14/TPG/1-02). Dr. Murphy is supported by a 2016 NSW Institute of Psychiatry Research Fellowship. Dr. Newby is supported by an Australian NHMRC Early Career Australian Clinical Fellowship (1037797). Prof Butow is supported by an NHMRC Senior Principal Research Fellowship.

Compliance with ethical standards

The study was approved by St Vincent’s Hospital Human Research Ethics Committee (LNR/15/SVH/333).

Conflict of interest

Funding for the Anxiety and Depression Pathway (ADAPT) Program was provided by a Cancer Institute NSW Translational Program Grant (ID 14/TPG/1-02). Dr. Murphy is supported by a 2016 NSW Institute of Psychiatry Research Fellowship. Dr. Newby is supported by an Australian NHMRC Early Career Australian Clinical Fellowship (1037797). Prof Butow is supported by an NHMRC Senior Principal Research Fellowship. There is no conflict of interest between these funding opportunities and the research outcome reported. The corresponding authors have full control of all primary data and agree to allow the journal to review the data if requested.

Supplementary material

520_2017_3617_MOESM1_ESM.docx (15 kb)
ESM 1 (DOCX 14 kb)

References

  1. 1.
    Mitchell AJ (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. The Lancet Oncology 12(2):160–174CrossRefPubMedGoogle Scholar
  2. 2.
    Linden W, Vodermaier A, MacKenzie R, Greig D (2012) Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord 141(2):343–351CrossRefPubMedGoogle Scholar
  3. 3.
    Hersch J, Juraskova I, Price M, Mullan B (2009) Psychosocial interventions and quality of life in gynaecological cancer patients: a systematic review. Psycho-Oncology 18:795–810CrossRefPubMedGoogle Scholar
  4. 4.
    Li M, Fitzgerald P, Rodin G (2012) Evidence-based treatment of depression in patients with cancer. J Clin Oncol 30(11):1187–1196CrossRefPubMedGoogle Scholar
  5. 5.
    Williams S, Dale J (2006) The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review. Br J Cancer 94(3):372–390CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Osborn RL, Demoncada AC, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 36(1):13–34CrossRefPubMedGoogle Scholar
  7. 7.
    Dieng M, Cust AE, Kasparian NA, Mann GJ, Morton RL. Economic evaluations of psychosocial interventions in cancer: a systematic review. Psycho-oncology. 2016:n/a-n/a.Google Scholar
  8. 8.
    Andrews G, Cuijpers P, Craske MG, McEvoy P, Titov N (2010) Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One 5(10):e13196CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Dear BF, Titov N, Perry KN, Johnston L, Wootton BM, Terides MD et al (2013) The Pain Course: a randomised controlled trial of a clinician-guided Internet-delivered cognitive behaviour therapy program for managing chronic pain and emotional well-being. Pain 154(6):942–950CrossRefPubMedGoogle Scholar
  10. 10.
    Newby JM, Twomey C, Yuan Li SS, Andrews G (2016) Transdiagnostic computerised cognitive behavioural therapy for depression and anxiety: a systematic review and meta-analysis. J Affect Disord 199:30–41CrossRefPubMedGoogle Scholar
  11. 11.
    Hedman E, Ljotsson B, Lindefors N (2012) Cognitive behavior therapy via the internet: a systematic review of applications, clinical efficacy and cost-effectiveness. Expert Rev Pharmacoecon Outcomes Res 12(6):745–764CrossRefPubMedGoogle Scholar
  12. 12.
    Olthuis JV, Watt MC, Bailey K, Hayden JA, Stewart SH (2016) Therapist-supported internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Syst Rev 3Google Scholar
  13. 13.
    Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD (2012) Initial evaluation of an internet intervention to improve the sleep of cancer survivors with insomnia. Psycho-Oncology 21(7):695–705CrossRefPubMedGoogle Scholar
  14. 14.
    Beatty L, Koczwara B, Wade T (2016) Evaluating the efficacy of a self-guided Web-based CBT intervention for reducing cancer-distress: a randomised controlled trial. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer 24(3):1043–1051CrossRefGoogle Scholar
  15. 15.
    Willems RA, Bolman CA, Mesters I, Kanera IM, Beaulen AA, Lechner L. Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial. Psycho-Oncology. 2016.Google Scholar
  16. 16.
    Newby JM, Mackenzie A, Williams AD, McIntyre K, Watts S, Wong N et al (2013) Internet cognitive behavioural therapy for mixed anxiety and depression: a randomized controlled trial and evidence of effectiveness in primary care. Psychol Med 1-14Google Scholar
  17. 17.
    Services MRCH, Board PHR (2000) A framework for development and evaluation of RCTs for complex interventions to improve health: Med Res Council.Google Scholar
  18. 18.
    Cornwall A, Jewkes R (1995) What is participatory research? Soc Sci Med 41(12):1667–1676CrossRefPubMedGoogle Scholar
  19. 19.
    Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRefGoogle Scholar
  20. 20.
    McAlpine H, Joubert L, Martin-Sanchez F, Merolli M, Drummond KJ (2015) A systematic review of types and efficacy of online interventions for cancer patients. Patient Educ Couns 98(3):283–295CrossRefPubMedGoogle Scholar
  21. 21.
    Andersson G, Cuijpers P, Carlbring P, Riper H, Hedman E (2014) Guided internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry: Off J World Psychiatri Assoc (WPA) 13(3):288–295CrossRefGoogle Scholar
  22. 22.
    Boykoff N, Moieni M, Subramanian SK (2009) Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Surviv 3(4):223–232CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Wilhelmsen M, Lillevoll K, Risør MB, Høifødt R, Johansen M-L, Waterloo K et al (2013) Motivation to persist with internet-based cognitive behavioural treatment using blended care: a qualitative study. BMC Psychiatry 13(1):1CrossRefGoogle Scholar
  24. 24.
    Moorey S, Greer S (2011) Oxford guide to CBT for people with cancer: Oxford University Press.Google Scholar
  25. 25.
    Harrison JD, Young JM, Price MA, Butow PN, Solomon MJ (2009) What are the unmet supportive care needs of people with cancer? A systematic review. Support Care Cancer 17(8):1117–1128CrossRefPubMedGoogle Scholar
  26. 26.
    Donkin L, Glozier N (2012) Motivators and motivations to persist with online psychological interventions: a qualitative study of treatment completers. J Med Internet Res 14(3):e91CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • A. Karageorge
    • 1
  • M. J. Murphy
    • 2
    Email author
  • J. M. Newby
    • 2
    • 3
  • L. Kirsten
    • 4
    • 5
  • G. Andrews
    • 2
  • K. Allison
    • 5
  • S. Loughnan
    • 2
  • M. Price
    • 5
  • J. Shaw
    • 5
  • H. Shepherd
    • 5
  • J. Smith
    • 2
  • P. Butow
    • 5
  1. 1.Clinical Psychology Unit, School of PsychologyUniversity of SydneyCamperdownAustralia
  2. 2.Clinical Research Unit for Anxiety and Depression (CRUfAD)UNSW School of Psychiatry at St Vincent’s HospitalSydneyAustralia
  3. 3.School of Psychology, Faculty of ScienceUNSW AustraliaKensingtonAustralia
  4. 4.Nepean Cancer Care CentreSydney West Cancer NetworkSydneyAustralia
  5. 5.Psycho-oncology Co-operative Research Group (PoCoG), Level 6, Chris O’Brien Lifehouse (C39Z)The University of SydneySydneyAustralia

Personalised recommendations