The Feasibility and Acceptability of a Cognitive Behavioral Therapy-based intervention for Patients with Advanced Colorectal Cancer

Colorectal Cancer

Teo I, et al. J Pain Symptom Manage 2020.


Context/ objectives: Advanced colorectal cancer and its treatment can bring about challenges associated with psychological distress. The primary aims of this study were to examine the feasibility and acceptability of a cognitive behavioral therapy (CBT)-based intervention to improve coping with the disease. The secondary aim is to evaluate preliminary intervention efficacy.

METHODS: Patients with advanced colorectal cancer in Singapore (N = 60) were randomized to either receive a 4-session CBT intervention immediately or be waitlisted. Intervention feasibility (i.e., recruitment and intervention adherence) and acceptability (i.e., participant satisfaction and cultural sensitivity) were assessed. Changes in psychological distress and self-efficacy were examined.

RESULTS: The study successfully recruited the intended sample (M age = 61, 62% men). A proportion (12%) reported Hospital Anxiety and Depression Scale (HADS) scores indicative of distress at baseline. The majority (88%) completed all sessions. Participants reported high rates of satisfaction (97%), helpfulness (96%) and cultural sensitivity (95%) of the intervention. The intervention group did not show decrease in psychological distress; however, self-efficacy in cancer-related coping (information seeking, effect size (ES) = 0.64, 95%CI [0.17, 0.85]; coping with side effects, ES=0.69, 95%CI [0.33, 0.82]; and maintaining positive attitude, ES=0.45, 95%CI [0.19, 0.79]) increased in the intervention group compared to the waitlisted group.

CONCLUSION: The CBT-based intervention was feasible and acceptable to patients in Singapore. There is not sufficient evidence to warrant a larger trial in this sample with low baseline distress. Future work should identify and target those who are most in need of support.