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An evaluation of the effectiveness of ‘Time to Adjust’ a group-based cognitive-behavioural-therapy (CBT) programme for patients recovering from cancer

Published online by Cambridge University Press:  12 May 2016

N. Likely  and
V. Switzer
N. Likely
Affiliation:
Psychologist in Clinical Training, University of Limerick, Limerick, Ireland
V. Switzer*
Affiliation:
Senior Clinical Psychologist, Department of Liaison Psychiatry & Psychological Medicine, University Hospital Limerick, Dooradoyle, Limerick, Ireland
*
*Address for correspondence: Dr V. Switzer, Reg. Psychol, Ps.S.I., Senior Clinical Psychologist, Department of Liaison Psychiatry & Psychological Medicine, University Hospital Limerick, Dooradoyle, Limerick, Ireland. (Email: valleri.switzer@hse.ie)
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Abstract

Objectives

‘Time to Adjust’ (TTA) is a 6-week group-based cognitive-behavioural-therapy programme for patients recovering from cancer. The TTA intervention is designed to facilitate patient’s adjustment to life after cancer by enhancing existing coping skills, developing new coping skills and drawing on peer support within the context of group delivery of the programme. The study aims to explore patient psychological adjustment and to identify features of the intervention that patients find most beneficial.

Methods

This retrospective repeated measures design study represents a clinical evaluation of a group-based intervention routinely delivered by the Cancer Psychology Service at University Hospital Limerick. TTA was open to patients with a cancer diagnosis who had completed their surgery, radiotherapy and chemotherapy treatment by the programme start date. Patients self-referred and suitability for the programme was assessed by pre-programme clinical interview. Pre- and post-intervention data from 59 participants was collected using self-report measures of stress and coping. A brief end-of-programme questionnaire provided descriptive feedback on patients’ experience of the programme.

Results

Findings revealed favourable trends in the psychological adjustment of patients. Self-reported depression, anxiety and negative adjustment was lower post-TTA.

Conclusions

This study indicates that TTA supports patients’ psychological recovery from cancer with multiple components of the programme facilitating psychological adjustment. Findings support the delivery of group-based therapeutic interventions for this patient group. Future research could use in-depth post-intervention interviews for a richer understanding of the programme benefits. Longer-term follow-up in could examine the degree to which benefits are maintained over time.

Keywords

CancerCBTpsycho-oncology
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 33 , Issue 4 , December 2016 , pp. 235 - 246
Copyright
© College of Psychiatrists of Ireland 2016 

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References

Andersen, BL, Andersen, B, DeProsse, C (1989). Controlled prospective longitudinal study of women with cancer. II Psychological outcomes. Journal of Consulting and Clinical Psychology 57, 692–697.Google Scholar
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77–101.Google Scholar
Burkett, VS, Cleeland, (2007). Symptom burden in cancer survivorship. Journal of Cancer Survivorship 1, 167–175.Google Scholar
Butow, PN, Bell, ML, Smith, AB, Fardell, JE, Thewes, B, Turner, J, Gilchrist, J, Beith, J, Girgis, A, Sharpe, L, Shih, S (2013). Conquer fear: protocol of a randomised controlled trial of a psychological intervention to reduce fear of cancer recurrence. BMC Cancer 13, 201.CrossRefGoogle ScholarPubMed
Crist, JV, Grunfeld, EA (2013). Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho‐Oncology 22, 978–986.Google Scholar
de Moor, JS, Mariotto, AB, Parry, C, Alfano, CM, Padgett, L, Kent, EE, Forsythe, L, Scoppa, S, Hachey, M, Rowland, JH (2013). Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiology Biomarkers & Prevention 22, 561–570.Google Scholar
Derogatis, LR (1994). Symptom Checklist-90-Revised. Minneapolis, MN: NCS Pearson.Google Scholar
DeSantis, C, Siegel, R, Jemal, A (2012). Cancer Treatment & Survivorship Facts & Figures 2012–2013. American Cancer Society: Atlanta, GA.Google Scholar
DeSantis, CE, Lin, CC, Mariotto, AB, Siegel, RL, Stein, KD, Kramer, JL, Alteri, R, Robbins, AS, Jemal, A (2014). Cancer treatment and survivorship statistics, 2014. CA: A Cancer Journal for Clinicians 64, 252–271.Google Scholar
Dolbeault, S, Cayrou, S, Bredart, A, Viala, AL, Desclaux, B, Saltel, P, Gauvain‐Piquard, A, Hardy, P, Dickes, P (2009). The effectiveness of a psycho‐educational group after early‐stage breast cancer treatment: results of a randomized French study. Psycho‐Oncology 18, 647–656.Google Scholar
DuHamel, KN, Mosher, CE, Winkel, G, Labay, LE, Rini, C, Meschian, YM, Austin, J, Greene, PB, Lawsin, CR, Rusiewicz, A, Grosskreutz, CL (2010). Randomized clinical trial of telephone-administered cognitive-behavioural therapy to reduce post-traumatic stress disorder and distress symptoms after hematopoietic stem-cell transplantation. Journal of Clinical Oncology 28, 3754–3761.Google Scholar
Edwards, BK, Noone, AM, Mariotto, AB, Simard, EP, Boscoe, FP, Henley, SJ, Jemal, A, Cho, H, Anderson, RN, Kohler, BA, Eheman, CR (2014). Annual Report to the Nation on the status of cancer, 1975–2010, featuring prevalence of comorbidity and impact on survival among persons with lung, colorectal, breast, or prostate cancer. Cancer 120, 1290–1314.Google Scholar
Espie, CA, Fleming, L, Cassidy, J, Samuel, L, Taylor, LM, White, CA, Douglas, NJ, Engleman, HM, Kelly, HL, Paul, J (2008). Randomized controlled clinical effectiveness trial of cognitive behaviour therapy compared with treatment as usual for persistent insomnia in patients with cancer. Journal of Clinical Oncology 26, 4651–4658.Google Scholar
Foster, C, Wright, D, Hill, H, Hopkinson, J, Roffe, L (2009). Psychosocial implications of living 5 years or more following a cancer diagnosis: a systematic review of the research evidence. European Journal of Cancer Care 18, 223–247.Google Scholar
Germino, BB, Mishel, MH, Crandell, J, Porter, L, Blyler, D, Jenerette, C, Gil, KM (2013). Outcomes of an uncertainty management intervention in younger African American and Caucasian breast cancer survivors. Oncology Nursing Forum 40, 82–92.Google Scholar
Gil, KM, Mishel, MH, Belyea, M, Germino, B, Porter, LS, Clayton, M (2006). Benefits of the uncertainty management intervention for African American and White older breast cancer survivors: 20-month outcomes. International Journal of Behavioural Medicine 13, 286–294.Google Scholar
Gotay, CC, Muraoka, MY (1998). Quality of life in long-term survivors of adult-onset cancers. Journal of the National Cancer Institute 90, 656–667.Google Scholar
Greer, S, Watson, M (1986). Mental adjustment to cancer: its measurement and prognostic importance. Cancer Surveys 6, 439–453.Google Scholar
Henselmans, I, Helgeson, VS, Seltman, H, de Vries, J, Sanderman, R, Ranchor, AV (2010). Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. Health Psychology 29, 160.Google Scholar
Hopko, DR, Armento, ME, Robertson, S, Ryba, MM, Carvalho, JP, Colman, LK, Mullane, C, Gawrysiak, M, Bell, JL, McNulty, JK, Lejuez, CW (2011). Brief behavioural activation and problem-solving therapy for depressed breast cancer patients: randomized trial. Journal of Consulting and Clinical Psychology 79, 834–849.Google Scholar
Hopko, DR, Funderburk, JS, Shorey, RC, McIndoo, CC, Ryba, MM, File, AA, Benson, K, Vitulano, M (2013). Behavioural activation and problem-solving therapy for depressed breast cancer patients: preliminary support for decreased suicidal ideation. Behaviour Modification 37, 747–767.Google Scholar
Jacobsen, PB, Andrykowski, MA (2015). Tertiary prevention in cancer care: understanding and addressing the psychological dimensions of cancer during the active treatment period. American Psychologist 70, 134.Google Scholar
Kim, Y, Carver, CS, Spillers, RL, Love-Ghaffari, M, Kaw, CK (2012). Dyadic effects of fear of recurrence on the quality of life of cancer survivors and their caregivers. Quality of Life Research 21, 517–525.CrossRefGoogle ScholarPubMed
Koch, L, Jansen, L, Brenner, H, Arndt, V (2013). Fear of recurrence and disease progression in long‐term (≥5 years) cancer survivors – a systematic review of quantitative studies. Psycho‐Oncology 22, 1–11.Google Scholar
Krebber, AMH, Buffart, LM, Kleijn, G, Riepma, IC, Bree, R, Leemans, CR, Becker, A, Brug, J, Straten, A, Cuijpers, P, Verdonck‐de Leeuw, IM (2014). Prevalence of depression in cancer patients: a meta‐analysis of diagnostic interviews and self‐report instruments. Psycho‐Oncology 23, 121–130.Google Scholar
Lebel, S, Tomei, C, Feldstain, A, Beattie, S, McCallum, M (2013). Does fear of cancer recurrence predict cancer survivors’ health care use? Supportive Care in Cancer 21, 901–906.Google Scholar
Levit, L, Balogh, E, Nass, S, Ganz, PA (2013). Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population; Board on Health Care Services (BHCS); Institute of Medicine (IOM), Washington, DC: Delivering high-quality cancer care: charting a new course for a system in crisis. National Academies Press (US).Google Scholar
Mann, E, Smith, MJ, Hellier, J, Balabanovic, JA, Hamed, H, Grunfeld, EA, Hunter, MS (2012). Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): a randomised controlled trial. The Lancet Oncology 13, 309–318.CrossRefGoogle ScholarPubMed
Marcus, AC, Garrett, KM, Cella, D, Wenzel, L, Brady, MJ, Fairclough, D, Pate‐Willig, M, Barnes, D, Powell Emsbo, S, Kluhsman, BC, Crane, L (2010). Can telephone counselling post‐treatment improve psychosocial outcomes among early stage breast cancer survivors? Psycho‐Oncology 19, 923–932.CrossRefGoogle ScholarPubMed
McKiernan, A, Steggles, S, Carr, A (2013). Understanding how people cope with cancer. Irish Psychologist 39, 218–223.Google Scholar
McKiernan, A, Steggles, S, Guerin, S, Carr, A (2010). A controlled trial of group cognitive behaviour therapy for Irish breast cancer patients. Journal of Psychosocial Oncology 28, 143–156.Google Scholar
Mehnert, A, Berg, P, Henrich, G, Herschbach, P (2009). Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors. Psycho-oncology 18, 1273–1280.Google Scholar
Mehnert, A, Koch, U, Sundermann, C, Dinkel, A (2013). Predictors of fear of recurrence in patients one year after cancer rehabilitation: a prospective study. Acta Oncologica 52, 1102–1109.Google Scholar
Meneses, KD, McNees, P, Loerzel, VW, Su, X, Zhang, Y, Hassey, LA (2007). Transition From Treatment to Survivorship: Effects of a Psychoeducational Intervention on Quality of Life in Breast Cancer Survivors. Oncology Nursing Forum 34, 1007–1016.Google Scholar
Mitchell, AJ, Chan, M, Bhatti, H, Halton, M, Grassi, L, Johansen, C, Meader, N (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, 160–174.CrossRefGoogle ScholarPubMed
Mols, F, Vingerhoets, AJ, Coebergh, JW, van de Poll-Franse, LV (2005). Quality of life among long-term breast cancer survivors: a systematic review. European Journal of Cancer 41, 2613–2619.Google Scholar
Moorey, S, Greer, S (2002). Cognitive Behaviour Therapy for People with Cancer. Oxford University Press: Oxford.Google Scholar
Mullan, F (1985). Seasons of survival: reflections of a physician with cancer. New England Journal of Medicine 313, 270–273.Google Scholar
National Cancer Registry Ireland (2012). Cancer fact sheet overview & most common cancers (http://www.ncri.ie/factsheets) Accessed July 2015.Google Scholar
Penedo, FJ, Molton, I, Dahn, JR, Shen, BJ, Kinsinger, D, Traeger, L, Siegel, S, Schneiderman, N, Antoni, M (2006). A randomized clinical trial of group-based cognitive-behavioural stress management in localised prostate cancer: development of stress management skills improves quality of life and benefit finding. Annals of Behavioural Medicine 31, 261–270.Google Scholar
Piet, J, Würtzen, H, Zachariae, R (2012). The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology 80, 1007.CrossRefGoogle Scholar
Phillips, KM, McGinty, HL, Gonzalez, BD, Jim, HS, Small, BJ, Minton, S, Andrykowski, MA, Jacobsen, PB (2013). Factors associated with breast cancer worry 3 years after completion of adjuvant treatment. Psycho‐Oncology 22, 936–939.Google Scholar
Scheier, MF, Helgeson, VS, Schulz, R, Colvin, S, Berga, S, Bridges, MW, Knapp, J, Gerszten, K, Pappert, WS (2005). Interventions to enhance physical and psychological functioning among younger women who are ending nonhormonal adjuvant treatment for early-stage breast cancer. Journal of Clinical Oncology 23, 4298–4311.Google Scholar
Stanton, AL (2012). What happens now? Psychosocial care for cancer survivors after medical treatment completion. Journal of Clinical Oncology 30, 1215–1220.Google Scholar
Stanton, AL, Ganz, PA, Rowland, JH, Meyerowitz, BE, Krupnick, JL, Sears, SR (2005). Promoting adjustment after treatment for cancer. Cancer 104, 2608–2613.Google Scholar
Stanton, AL, Rowland, JH, Ganz, PA (2015). Life after diagnosis and treatment of cancer in adulthood: contributions from psychosocial oncology research. American Psychologist 70, 159.Google Scholar
Stewart, BW, Wild, CP (editors) (2014). World Cancer Report 2014. International Agency for Research on Cancer, World Health Organisation: Geneva, Switzerland.Google Scholar
Syrjala, KL, Martin, PJ, Lee, SJ (2012). Delivering care to long-term adult survivors of hematopoietic cell transplantation. Journal of Clinical Oncology 30, 3746–3751.CrossRefGoogle ScholarPubMed
Watson, M, Greer, S, Bliss, JM (1989). Mental adjustment to cancer scale. The Chiswick Centre London: GL Assessment Limited.Google Scholar
Watson, M, Homewood, J (2008). Mental adjustment to Cancer Scale©: psychometric properties in a large cancer cohort. Psycho‐Oncology 17, 1146–1151.CrossRefGoogle Scholar
Weaver, KE, Forsythe, LP, Reeve, BB, Alfano, CM, Rodriguez, JL, Sabatino, SA, Hawkins, NA, Rowland, JH (2012). Mental and physical health-related quality of life among US cancer survivors: population estimates from the 2010 National Health Interview Survey. Cancer Epidemiology Biomarkers & Prevention 21, 2108–2117.Google Scholar