Problem-focussed interactive telephone therapy for cancer patients: A phase II feasibility trial
Watson M., White C., Davolls S., Mohammed A., Lynch A., Mohammed K.
Objective The study aimed to evaluate Problem-Focussed Interactive Telephone Therapy, an individual psychological therapy based on cognitive-behavioural therapy adapted for telephone delivery to cancer patients with high psychological needs. Methods A non-randomised, within-group prospective design was used. Outcome measures pre-therapy and post-therapy included were as follows: Hospital Anxiety and Depression Scale, Mental Adjustment to Cancer Scale: helpless/hopeless sub-scale only, Checklist of Cancer Concerns, Cancer Coping Questionnaire and EQ-5D quality of life. A study-specific Service Evaluation Questionnaire was included. Eligible patients were either (i) offered out-patient screening for anxiety/depression/ helplessness (n = 649) or (ii) referred for psychological care by oncology clinicians (n = 160). Results Thirty two percent (36/114) of screen-identified cases and 22% (35/160) of referred patients participated, and 42 were available for analysis. There were significant post-therapy improvements in Hospital Anxiety and Depression Scale anxiety (p = 0.002) and depression (p = 0.003), Mental Adjustment to Cancer Scale helpless/hopeless (p = 0.036), cancer concerns (p = 0.005) and overall quality of life (p = 0.048). Overall, 81% (34/42) of participants were defined as clinical cases at baseline and 32% were no longer cases post-therapy. There were significant improvements in coping consistent with the therapy method. Conclusions A minority of symptomatic patients opt for telephone psychological therapy; however, where they do, there are significant improvements indicating that telephone-delivered therapy is feasible in patients with high needs. Findings are discussed in relation to current issues on the implementation of distress screening and psychological therapy provision within clinical settings. Copyright © 2012 John Wiley & Sons, Ltd. Copyright © 2012 John Wiley & Sons, Ltd.