Objectives: Despite the demonstrable psychosocial impact of cancer diagnoses, less than 25% of distressed individuals elect to attend face-to-face therapy. Therefore this study developed and evaluated the efficacy of an internet cognitive behaviour therapy self-help program for cancer-distress.
Methods: Participants were 60 individuals in the acute survivorship phase (recently diagnosed), treated with curative intent, recruited from March 2011-November 2012. An interim analysis of the first 53 participants enrolled is the focus of the current report. Participants were randomised to receive a password protected 6 week program; either (a) the intervention, or (b) an internet attention-control. Measures of distress (negative affect, traumatic stress), coping and health-related quality of life were administered at baseline, post-treatment, and 3 month follow-up. Changes over time between groups were analysed using Linear Mixed Models, and qualitative feedback was obtained both during the program (end of module feedback), and at follow-up assessments.
Preliminary results/progress: From pre- to post-treatment, a significant interaction was found, with intervention participants experiencing reductions in traumatic stress (Mpre=12.09, SE=0.53; Mpost=9.84, SE=0.49) compared to small increases occurring in controls (Mpre=12.09, SE=0.53; Mpost=13.39, SE=0.44; p=.04). A similar trend approaching significance was also obtained for anxious preoccupation. However, these statistically significant effects were not sustained at follow-up. Qualitative feedback was largely positive. Future research could usefully explore ways of maintaining improvements over time, such as via the inclusion of a booster module.
Discussion: Given the access barriers to obtaining psychosocial support in Australia, innovative methods of providing psychosocial care are required. This research program represents one method of partially addressing this gap in resources. In addition, early intervention during the acute survivorship phase has the potential to prevent distress from escalating over the survivorship period. The findings of this study will be extended in a three year NHMRC-funded national multi-site RCT commencing in 2013.