Personalizing cognitive behavioral therapy for cancer-related fatigue using ecological momentary assessments followed by automated individual time series analyses: a case report series
Open accessAbstract
INTRODUCTION: A common approach to personalizing psychological interventions is the allocation of treatment modules to individual patients based on cut-off scores on questionnaires, which are mostly based on group studies. However, this way, intraindividual variation and temporal dynamics are not taken into account. Automated individual time series analyses are a possible solution, since these can identify the factors influencing the targeted symptom in a specific individual, and associated modules can be allocated accordingly. The aim of this study was to illustrate how automated individual time series analyses can be applied to personalize cognitive behavioral therapy for cancer-related fatigue in cancer survivors and how this procedure differs from allocating modules based on questionnaires. METHODS: = 3). Patients completed ecological momentary assessments at the start of therapy, and after three treatment modules (approximately 14 weeks). Assessments were analyzed with AutoVAR, an R package that automates the process of finding optimal vector autoregressive models. The results informed the treatment plan. RESULTS: Three cases were described. From the ecological momentary assessments and automated time series analyses three individual treatment plans were constructed, in which the most important predictor for cancer-related fatigue was treated first. For two patients, this led to the treatment ending after the follow-up ecological momentary assessments. One patient continued treatment until six months, the standard treatment time in regular treatment. All three treatment plans differed from the treatment plans informed by questionnaire scores. DISCUSSION: This study is one of the first to apply time series analyses in systematically personalizing psychological treatment. An important strength of this approach is that it can be used for every modular cognitive behavioral intervention where each treatment module addresses specific maintaining factors. Whether or not personalized CBT is more efficacious than standard, non-personalized CBT remains to be determined in controlled studies comparing it to usual care.
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Harnas et al. (2021) provide a case report series on personalizing cognitive behavioural therapy for cancer-related fatigue by means of ecological momentary assessments.
“The complexity of this kind of technologically enhanced interventions is nicely illustrated by Harnas et al. (2021) in this special issue, who provide a case report series on personalizing cognitive behavioural therapy for cancer-related fatigue by means of ecological momentary assessments.”
From Special issue on digital health interventions in chronic medical conditions: Editorial (2022) · cites this paper as Harnas et al., 2021
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Bootsma, T. I., Schellekens, M. P. J., van Woezik, R. A. M., Slatman, J., & van der Lee, M. L. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100568 · Cited by 16 · see citing works
Special issue on digital health interventions in chronic medical conditions: Editorial
Baumeister, H., Ebert, D. D., & Snoek, F. (2022) · Internet Interventions · doi:10.1016/j.invent.2021.100457 · Cited by 13 · see citing works
“…(Bendig et al., 2021; Domhardt et al., 2021b; Terhorst et al., 2021; Terpstra et al., 2021; van der Hout et al., 2021), while two studies focus on the next development stage of digital interventions, aiming for personalisation and adaptiveness (Harnas et al., 2021; Nap-van der Vlist et al., 2021).”
BackgroundInfluential
- Authors
- Harnas, S. J., Knoop, H., Booij, S. H., & Braamse, A. M. J.
- Affiliations
- Amsterdam Public Health (NL)
- University of Groningen (NL)
- Corresponding author
- Harnas, Susan J.
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 25
- Pages
- 100430
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC8350606
- OpenAlex
- W3186044681
- Cited by
- 12
- References
- 45
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 2
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- KWF Kankerbestrijding (11351)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- cancer-related fatigue, ecological momentary assessment, vector autoregression, cancer survivors, within-person variability, temporal dynamics of symptoms
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