Patient and provider perceptions of Internet-delivered cognitive behavior therapy for recent cancer survivors



Although most cancer survivors adjust well, a subset experiences clinical levels of anxiety and depression following cancer treatment. Internet-delivered cognitive behavior therapy (iCBT) is a promising intervention for symptoms of anxiety and depression among survivors; however, patient and provider perceptions of iCBT have not been examined.


We employed an exploratory qualitative method and conducted semi-structured interviews with 13 cancer survivors and 10 providers to examine iCBT strengths and weaknesses, areas for improvement, and perceived barriers to program completion. A thematic content analysis approach was used to analyze the data.


The majority of survivors liked the flexible, convenient, and private nature of the program. Many viewed the program as helping them feel less alone following cancer treatment. Areas of improvement included suggestions of additional information regarding cancer treatment side effects. Barriers to completing the program were identified by a minority of survivors and included finding time to complete the program and current symptoms. Providers liked the program’s accessibility and its ability to provide support to patients after cancer treatment. All providers perceived the program as useful in their current work with survivors. Concerns around the fit of the program (e.g., for particular patients) were expressed by a minority of providers.


Results provide additional evidence for the acceptability of an iCBT program among recent cancer survivors and providers in oncology settings. The current study highlights the value of research exploring iCBT for cancer survivors and provides insights for other groups considering Internet-delivered care for survivors.

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We are grateful to all of the cancer survivors and providers for their time and insights that made this study possible. At the time that this research was conducted, the first author, Dr. Nicole Alberts, was funded by a Frederick Banting and Charles Best Canada Graduate Scholarship—Doctoral Award from the Canadian Institutes of Health Research, Ottawa, ON, Canada.

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Corresponding author

Correspondence to Nicole M. Alberts.

Ethics declarations

The study was approved by the Human Research Ethics Committees, and the component involving survivor interviews was registered, in conjunction with the feasibility trial, with the Current Controlled Trials Register (ISRCTN60887190).

Conflict of interest

Dr. Alberts and the co-authors, Drs. Hadjistavropoulos, Titov, and Dear do not have any interests that might be interpreted as influencing the current study. At the time that this research was conducted, the first author, Dr. Alberts, was funded by a Frederick Banting and Charles Best Canada Graduate Scholarship—Doctoral Award from the Canadian Institutes of Health Research, Ottawa, ON, Canada. Dr. Alberts does not have a financial relationship with the Canadian Institutes of Health Research. Dr. Alberts has full control of all primary data and agrees to allow Supportive Care in Cancer to review the data if requested.

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Alberts, N.M., Hadjistavropoulos, H.D., Titov, N. et al. Patient and provider perceptions of Internet-delivered cognitive behavior therapy for recent cancer survivors. Support Care Cancer 26, 597–603 (2018).

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  • Cancer
  • Cognitive behavior therapy
  • Internet-delivered
  • Survivorship
  • Anxiety
  • Depression