No effect of CBT‐based online self‐help training to reduce fear of cancer recurrence: First results of the CAREST multicenter randomized controlled trial

Abstract

Objective: Fear of cancer recurrence (FCR) is a common consequence of surviving cancer; therefore, easily accessible self-help training could help many cancer survivors deal with FCR at low costs. The CAncer REcurrence Self-help Training (CAREST) trial evaluates the effectiveness of an online-tailored self-help training on the basis of evidence-based cognitive behavioral therapy principles in breast cancer survivors.Also, possible predictors for benefitting from the online self-help training were examined.Methods: This multicenter randomized controlled trial included 262 female breast cancer survivors, randomly assigned to either online self-help training (n = 130) or care as usual (CAU; n = 132). Participants completed questionnaires at baseline (T0), 3 months (T1; after intervention), and 9 months (T2). The primary outcome was FCR (Fear of Cancer Recurrence Inventory Severity subscale). Both effectiveness and predictors were analyzed with latent growth curve modeling (LGCM) according to the intention-to-treat principle. Results:LGCM showed no differences between the average latent slope in both groups (χ 2 1 = .23, P = .63), suggesting that the treatments did not differ in their change in FCR over time. Moreover, no differences were found in the effects of the predictors on the latent slope in both groups (χ 2 1 = .12, P = .73), suggesting that no significant predictors were found for the effect of the intervention on FCR. Conclusion:There was no effect of the CBT-based online self-help training "Less fear after cancer" in the current study. Therefore, we recommend adding professional support to online interventions for FCR.

Predictors and Effects of Usage of an Online Mindfulness Intervention for Distressed Cancer Patients: Usability Study

“…It is possible that patients with a high fear of recurrence are more likely to avoid participation, as it means being confronted with their fear. This is in line with a recent study on online self-help for fear of cancer recurrence that found that most patients do not login or express a need for support [ 45 ]. As fear of recurrence is an unmet need among cancer patients [ 46 ], this group might need more information prior to enrollment in an intervention like eMBCT [ 47 ].…”

Bridging the distance: Continuing psycho‐oncological care via video‐consults during the COVID‐19 pandemic

“…Clients mainly suffer from severe cancer-related fatigue, anxiety, trauma, stressrelated and depressive disorders, relationship problems and/or prolonged grief disorder. Since 2009 the institute offers specific internetbased interventions for cancer patients, such as Mindfulness-Based Cognitive Therapy (MBCT) for cancer-related fatigue 1,2 and Anxiety and Depression, 3,4 self-help and blended Cognitive Behavioural Therapy (CBT) for fear of cancer recurrence 5,6 within a secure environment.…”

Study protocol: a randomized controlled trial comparing the efficacy of therapist guided internet-delivered cognitive therapy (TG-iConquerFear) with augmented treatment as usual in reducing fear of cancer recurrence in Danish colorectal cancer survivors

“…Web-based interventions have the potential to fill an important gap in quality cancer care by augmenting limited available mental health services [45]. However, there is some evidence that entirely self-guided web-based FCR interventions may have limited efficacy, and it has been suggested that therapist input may increase efficacy [46]. Web-based therapist-guided cognitive therapy has advantages for both patients and providers and effects appear comparable to traditional face-to-face therapy in treating distress in patients with cancer [47,48].…”