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



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.


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.


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.


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.


Cancer Depression Anxiety Cognitive behavioural therapy (CBT) Qualitative Acceptability 



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)


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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

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