An examination of depression, anxiety, and fear of recurrence among cancer survivors who participated in a virtual cognitive behavioral therapy (CBT)-based telephone coaching program
Abstract
Background Depression, anxiety, and fear of recurrence (FOR) are prevalent among cancer survivors, and it is recommended that they have access to supportive services and resources to address psychosocial needs during follow-up care. This study examined the impact of a virtual cognitive behavioral therapy (CBT)-based telephone coaching program (BounceBack®) on depression, anxiety, and FOR. Method Through the After Cancer Treatment Transition (ACTT) clinic at the Women's College Hospital (Toronto, Canada), eligible participants were identified, consented, and referred to the BounceBack® program. Program participation involved completion of self-selected online workbooks and support from trained telephone coaches. Measures of depression (PHQ-9), anxiety (GAD-7), and FOR (fear of cancer recurrence inventory, FCRI) were collected at pre-intervention (baseline) and post-intervention (6-month and 12-month time points). For each psychosocial measure, paired t-tests compared mean scores between study time points. Participant experiences and perceptions were collected through a survey. Results Measures of depression and anxiety significantly improved among participants from pre-intervention to post-intervention. Scores for PHQ-9 and GAD-7 decreased from moderate to mild levels. Measure of FOR also significantly improved, while FCRI sub-scale scores significantly improved for 5 of the 7 factors that characterize FOR (triggers, severity, psychological distress, functional impairment, ins…
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The feasibility and satisfaction studies in the review that showed the highest preliminary effectiveness were Onco-step, Kaiketsu-app and BounceBack.
“The feasibility and satisfaction studies in our review that showed the highest preliminary effectiveness were Onco-step [56], Kaiketsu-app [50, 58] and BounceBack [57].”
Other reported drawbacks included intervention perceived as impersonal, preference for printed workbooks, higher dropout rates, technical updates, and scheduling challenges.
“Other drawbacks reported were: intervention perceived as impersonal [57], preference for printed workbooks over the website [37], higher dropout rates [34], technical improvements like keeping on top of the browser updates [47], scheduling challenges [53]”
Qualified therapists delivered the intervention in ten reviewed studies, most often alongside website self-guided materials.
“Qualified therapists delivered the intervention in ten reviewed studies, most often alongside the website self-guided materials [37, 43–45, 53, 56, 57, 59, 61].”
In studies that utilised telecoaching, it was reported to increase intervention adherence, engagement, site use, and retention.
“In the studies that utilised telecoaching, it was reported to increase intervention adherence and engagement, site use and retention [43], to help integrate what the survivors had learned, to provide clarification, and to prepare participants for future scenarios [57].”
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“Three studies had phone communication as an additional element [43, 50, 57].”
BackgroundMethodInfluential
- Authors
- Nguyen, P., Heisey, R., Quenneville, C., Goulbourne, E., Khan, R., Rinaldo, E., Chagigiorgis, H., Shields, R., & Townsley, C.
- Affiliations
- Women's College Hospital (CA)
- University of Toronto (CA)
- Canadian Mental Health Association (CA)
- Corresponding author
- Nguyen, Patricia
- Venue
- Supportive Care in Cancer
- Published
- 2022-05-24
- Volume
- 30
- Issue
- 9
- Pages
- 7323-7332
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W4281387811
- Cited by
- 9
- References
- 11
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 3 · 2023: 2
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- cancer survivors, depression, anxiety, fear of recurrence, cognitive behavioral therapy, telephone coaching, virtual intervention, psychosocial support, intervention satisfaction
- MeSH terms
- Mentoring, Cancer Survivors, Anxiety, Depression, Fear, Female, Humans, Neoplasms, Telephone, Cognitive Behavioral Therapy
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