Randomised controlled trial of internet‐delivered cognitive behaviour therapy for clinical depression and/or anxiety in cancer survivors (iCanADAPT Early)
Open accessAbstract
Purpose: To evaluate internet‐delivered cognitive behavioural therapy (iCBT) on clinical depression and/or anxiety, distress, fear of cancer recurrence, and quality of life in cancer survivors. Methods: Random assignation of 114 participants to iCBT or treatment‐as‐usual (TAU). The clinician‐supervised iCBT program (iCanADAPT Early) consisted of eight lessons over 16 weeks. Self‐report questionnaires occurred at baseline, midpoint, and posttreatment for both groups with 3‐month follow‐up for iCBT participants. A mixed modelling approach to compare groups occurred. Results: iCBT was superior to TAU on all outcome measures at posttreatment. Compared with TAU, the iCBT group showed a significant decrease over time in anxiety and depression symptoms (primary outcome, Hospital Anxiety and Depression Scale, Hedges g = 1.51). Additionally the iCBT group had significantly lower general distress (Kessler‐10, g = 1.56), fear of cancer recurrence (Fear of Cancer Recurrence Inventory, g = 0.39), and significantly higher quality of life (Functional Assessment of Cancer Therapy—General, g = 0.74) at posttreatment compared with the TAU group. High adherence and satisfaction were found for iCBT with low clinician time. Conclusion: Clinician‐supervised iCBT has significant benefits for cancer survivors with clinical depression and anxiety disorders.
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Effectiveness studies of iCBT interventions for depression and anxiety among cancer patients and survivors are only recently emerging, and most studies have included people with all cancer types rather than focusing only on one type of cancer.
“Effectiveness studies of iCBT interventions for depression and anxiety among cancer patients and survivors are only recently emerging, and most studies have included people with all cancer types rather than focusing only on one type of cancer”
From A randomised controlled trial comparing internet-delivered cognitive behavioural therapy (iCBT) with and without main carer access versus treatment-as-usual for depression and anxiety among breast cancer survivors: Study protocol (2021) · cites this paper as Murphy et al., 2019
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredNo study has targeted depressive and anxiety symptoms in iCBT interventions specifically with breast cancer survivors with all cancer stages.
“First of all, no study has targeted depressive and anxiety symptoms in iCBT interventions specifically with breast cancer survivors with all cancer stages.”
From A randomised controlled trial comparing internet-delivered cognitive behavioural therapy (iCBT) with and without main carer access versus treatment-as-usual for depression and anxiety among breast cancer survivors: Study protocol (2021) · cites this paper as Murphy et al., 2019
The Study limitations section (4.1; page unavailable) says this iCBT intervention was designed for early-stage cancer survivors and did not assess people living with advanced cancer. The paper also describes its participants as predominantly, rather than exclusively, breast cancer survivors. These passages show that this trial was not a breast-cancer-specific, all-stage study, but they do not establish the broader claim that no such study existed. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThere are promising studies regarding anxiety and depression using eHealth with different psychological interventions, but the results are heterogeneous.
“There are promising studies regarding anxiety and depression using eHealth with different psychological interventions.9,14-17 However, the results are heterogeneous.14,15”
From Effects of a Video Sequence Based Intervention on Anxiety, Fatigue and Depression in Cancer Patients: Results of a Randomized Controlled Trial. (2023) · cites this paper as [16]
The Introduction reports preliminary efficacy for online interventions in cancer survivors, and Results §3.3.1 reports significant improvements in anxiety and depression with internet-delivered CBT. The paper does not establish that results across eHealth studies using different psychological interventions are heterogeneous; it evaluates one CBT intervention. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe duration of the interventions reviewed ranged from a one-off reading of an online psychoeducational booklet with a follow-up one week later to a 16-week program.
“The duration of the interventions reviewed ranged from a one-ff reading an online psychoeducational booklet with a follow-up one week later [54] to a 16-week program [42, 33].”
Clinician supervision was present in four reviewed studies.
“Clinician supervision to a lesser extent (e.g. asynchronous communication, providing feedback, monitoring, tele coaching if required [34, 40, 42, 49, 56] was present in four studies [34, 40, 42, 49, 56].”
These outcomes have been chosen based on recommendations by current treatment guidelines or on their establishment in previous psycho-oncological and e-mental health trials.
“These outcomes have been chosen based on recommendations by current treatment guidelines (German Clinical Practice Guideline) or on their establishment in previous psycho-oncological and e-mental health trials.”
Various studies have found benefits of CBT to apply to web-delivered CBT for cancer patients.
“Various studies have found these benefits to apply to web-delivered CBT for cancer patients (18, 28, 29).”
Transdiagnostic iCBT is effective in community samples and cancer survivors.
“transdiagnostic iCBT is effective in community samples (Newby et al., 2016; Pasarelu et al., 2017) and cancer survivors (Murphy et al., 2020; Dirkse et al., 2019).”
From A mixed methods pilot and feasibility open trial of internet-delivered cognitive behaviour therapy (iCanADAPT Advanced) for people with advanced cancer with depression and/or anxiety (2021) · cites this paper as Murphy et al., 2020
The general positive direction on all measures is in keeping with the changes seen in a RCT of transdiagnostic iCBT in cancer survivors with clinical depression and/or anxiety.
“The general positive direction on all measures is in keeping with the changes seen in a RCT of transdiagnostic iCBT in cancer survivors with clinical depression and/or anxiety (Murphy et al., 2020).”
From A mixed methods pilot and feasibility open trial of internet-delivered cognitive behaviour therapy (iCanADAPT Advanced) for people with advanced cancer with depression and/or anxiety (2021) · cites this paper as Murphy et al., 2020
A randomised controlled trial of iCBT for clinical depression and/or anxiety revealed that cancer survivors in the iCBT group showed significant reductions in anxiety and depression symptoms, general distress, fear of cancer recurrence, and significantly higher quality of life at post-treatment compared to the survivors receiving treatment-as-usual.
“a randomised controlled trial of iCBT for clinical depression and/or anxiety revealed that cancer survivors in the iCBT group showed significant reductions in anxiety and depression symptoms, general distress, fear of cancer recurrence, and significantly higher quality of life at post-treatment compared to the survivors receiving treatment-as-usual”
The data from a randomised controlled trial of an iCBT programme for depression and anxiety among cancer survivors revealed a large within-between interaction effect size for the HADS-Total after comparing pre-treatment and post-treatment scores of the iCBT and TAU.
“The data from a randomised controlled trial of an iCBT programme for depression and anxiety among cancer survivors revealed a large within-between interaction effect size for the HADS-Total after comparing the pre-treatment and post-treatment scores of the iCBT and the TAU (Murphy et al., 2019).”
Murphy et al.'s study (2019) evaluated the effects of iCBT on clinical depression and/or anxiety among cancer survivors, but they only included survivors with early-stage cancer and their findings may not be generalisable for those living with advanced cancer.
“Although Murphy et al.'s study (2019) evaluated the effects of iCBT on clinical depression and/or anxiety among cancer survivors, they only included survivors with early-stage cancer and their findings may not be generalisable for those living with advanced cancer.”
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References 31 · Cited by 93
Research works printed but not linked: 1
- [11]11. Brown TA, Barlow DH. Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5).: Adult Version. Client Interview Schedule: Oxford University Press; 2014.
- Authors
- Murphy, M. J., Newby, J. M., Butow, P., Loughnan, S. A., Joubert, A. E., Kirsten, L., Allison, K., Shaw, J., Shepherd, H. L., Smith, J., & Andrews, G.
- Affiliations
- UNSW Sydney (AU)
- The University of Sydney (AU)
- Corresponding author
- Murphy, M.J.
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2019-11-12
- Volume
- 29
- Issue
- 1
- Pages
- 76-85
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- OpenAlex
- W2982489614
- Cited by
- 93
- References
- 31
- Citations by year
- 2026: 9 · 2025: 16 · 2024: 21 · 2023: 18 · 2022: 16 · 2021: 8 · 2020: 5
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- Cancer Institute NSW (14/TPG/1‐02)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- internet-based cognitive behavioral therapy, cancer survivors, depression, anxiety, fear of cancer recurrence, psychological distress, quality of life, medication adherence
- MeSH terms
- Cancer Survivors, Internet-Based Intervention, Adult, Anxiety, Depression, Female, Humans, Male, Middle Aged, Cognitive Behavioral Therapy
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