Pilot Feasibility Study of a Telephone-Based Couples Intervention for Physical Intimacy and Sexual Concerns in Colorectal Cancer

Abstract

No studies have tested interventions addressing the sexual concerns of colorectal cancer patients and their partners. We report findings from a pilot feasibility study of a novel telephone-based Intimacy Enhancement protocol that addresses the intimacy and sexual concerns of couples facing colorectal cancer. Based on a flexible coping model (Reese, Keefe, Somers, & Abernethy, 2010), the intervention was designed to help couples make cognitive and behavioral shifts in their intimate relationships. Eighteen individuals (9 dyads) completed the intervention and completed measures of feasibility (frequency, ease of use, and helpfulness of skills, ratings of rapport), program evaluations, and measures of sexual and relationship functioning. Most participants reported that the intervention was “quite a bit” or “extremely helpful” and that they had used the skills taught within the past week. The skills most commonly practiced and perceived as most helpful tended to be behavioral (e.g., trying a new sexual activity). The largest effect sizes (≥ .60) were found for sexual distress, sexual function (female), and sexual communication. Findings from this pilot study suggest that the Intimacy Enhancement protocol is feasible and holds promise for improving sexual and intimacy outcomes in colorectal cancer patients and their partners. Research and clinical implications are discussed.

An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability

“…Future research should focus on delivery modalities that decrease burden and increase acceptability in a larger proportion of caregivers (e.g., those who are feeling too overwhelmed to attend in-person intervention sessions). Telephone interventions have been successful in providing efficacious psychosocial interventions for cancer patients and caregivers [36][37][38][39] and recent research on web-based interventions [40][41][42] and interventions using Smart phones and other delivery platforms [43] appear promising. These interventions provide more flexibility and cancer caregivers report they would reduce burden [44].…”

Importance of sexuality in colorectal cancer: predictors, changes, and response to an intimacy enhancement intervention

“…Pilot studies [14,17] of this four-session telephone-based intervention in colorectal cancer found positive effects for all sexual and relationship outcomes for partners, and several important outcomes for patients. An intriguing possibility is that alongside improvements in sexual and intimacy-related outcomes, patients and partners might also experience changes in the importance they assign to sexuality within their self-views (see Fig.…”

“…Integrating this model of flexible coping into an approach grounded in cognitive behavioral therapy for couples [15] and sex therapy approaches (e.g., sensate focus exercises) [16], a skills-based intimacy enhancement intervention was developed for couples in which one partner was diagnosed with colorectal cancer [14]. Pilot studies [14,17] of this four-session telephone-based intervention in colorectal cancer found positive effects for all sexual and relationship outcomes for partners, and several important outcomes for patients.…”

“…This model emphasizes shifting sexuality beliefs away from more rigid notions of performance-based sexual function and activity (i.e., sex equals intercourse) toward a more Bflexiblef ramework [14] in which sexuality is defined and experienced in broader, more inclusive ways. This model addresses both the centrality (e.g., how important sexuality is relative to other aspects of the self) and definition of sexual activity and function (e.g., how patients conceptualize sexual function and activity, such as narrowly or broadly).…”

Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study.

“…While physical intimacy includes sexual behaviors such as intercourse and genital touching, it can also include non-sexual behaviors (e.g., cuddling, hand-holding), both of which were IE intervention targets. The IE intervention was telephone-based to reduce participant burden and consisted of four sessions (Session 1: goal-setting; Session 2: intimacy-related communication; Session 3: cognitive restructuring and behavioral engagement in intimacy-building activities; Session 4: planning ahead); home practice exercises strengthened skill acquisition (for detailed information on the IE protocol, see Barsky Reese et al, 2014; Reese et al, 2012). Overall, the intervention was found to have positive effects on patient and partner sexual outcomes (e.g., sexual function, sexual distress) and intimacy outcomes (e.g., emotional intimacy, communication) across these studies, with particularly strong effects on sexual function and distress.…”