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Fjermestad KW, Wallin MH, Naujokat F, McLeod BD, Silverman WK, Öst LG, Lerner MD, Heiervang ER, Wergeland GJ. Group cohesion and alliance predict cognitive-behavioral group treatment outcomes for youth with anxiety disorders. Cogn Behav Ther 2024:1-19. [PMID: 39105346 DOI: 10.1080/16506073.2024.2385906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 07/24/2024] [Indexed: 08/07/2024]
Abstract
Knowledge about how to enhance group cognitive behavioral therapy (GCBT) outcomes is needed. In a randomized controlled effectiveness trial, we examined group cohesion (the bond between group members) and the alliance (the client-clinician bond) as predictors of GCBT outcomes. The sample was 88 youth (M age 11.7 years, SD = 2.1; 54.5% girls; 90.7% White) with anxiety disorders. Observers rated group cohesion and alliance in 32 sessions from 16 groups. We examined early group cohesion and alliance (r = .50, p < .001) and group cohesion and alliance change from early to late in treatment in relation to outcomes using generalized estimation equations accounting for nesting within groups (ICCs .31 to .55). The outcomes were diagnostic recovery, clinical severity, and parent- and youth-reported anxiety symptoms, each at post-treatment, 12-months, and 4-years follow-up. There were more significant associations with 4-years follow-up than earlier outcomes. Clinical severity and parent-reported anxiety symptoms were more frequently predicted than diagnostic recovery. Clinician- and parent-reported outcomes were far more frequently significantly predicted by cohesion and alliance than youth-rated outcomes. We conclude that group cohesion and alliance are related but distinct variables, both associated with some GCBT outcomes for as long as 4 years after treatment.
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Affiliation(s)
| | - Malin H Wallin
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Wendy K Silverman
- Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Lars-Göran Öst
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Einar R Heiervang
- Tynset Child and Adolescent Mental Health Clinic, Innlandet Hospital Trust, Lillehammer, Norway
| | - Gro Janne Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
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2
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Vaagan A, Haaland-Øverby M, Eriksen AA, Fredriksen K, Stenov V, Varsi C, Ingadóttir B, Cleal BR, Alvheim AR, Westermann KF, Strømme H, Kristjansdottir OB. Group-based patient education via videoconference: A scoping review. PATIENT EDUCATION AND COUNSELING 2024; 118:108026. [PMID: 37939596 DOI: 10.1016/j.pec.2023.108026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/12/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To summarize recent evidence on the feasibility, acceptability, and effectiveness of videoconference (VC) group-based patient and caregiver education. METHODS Systematic searches of the literature were conducted. Data was extracted on the characteristics of the studies and interventions and on the feasibility, acceptability, and effectiveness of the interventions. RESULTS From 12,570 hits, 65 studies were eligible for inclusion. Their results confirmed previously identified tendencies of high feasibility and acceptability of VC group patient education, and improved health outcomes. However, evidence of effectiveness is limited, and the quality of studies is varied. Several patient and caregiver groups also remain under-researched. Only four studies stated that facilitators were trained in using VC-technology. CONCLUSION VC group-based patient and caregiver education is feasible and acceptable and may improve health outcomes for participant patients and caregivers. However future research should increase the number of high-quality randomized controlled trials to establish the effectiveness of VC group-based education for several groups of patients and caregivers. Studies of the training of facilitators is also warranted. PRACTICE IMPLICATIONS The results suggest that interventions should be more accessible. An overview of the recent evidence may also stimulate the development and evaluation of VC group-based patient and caregiver education.
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Affiliation(s)
- André Vaagan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Postbox 4959 Nydalen, 0424 Oslo, Norway.
| | - Mette Haaland-Øverby
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Kari Fredriksen
- Learning and Mastery Center, Stavanger University Hospital, Stavanger, Norway
| | - Vibeke Stenov
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Cecilie Varsi
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway,; Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | - Brynja Ingadóttir
- Faculty of Nursing and Midwifery, University of Iceland, Reykjavik, Iceland
| | - Bryan Richard Cleal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Anita Røyneberg Alvheim
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Mental health team West, Primary care of the capital area, Reykjavik, Iceland
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3
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Fjermestad KW, McLeod BD, Silverman WK, Bjaastad JF, Lerner MD, Wergeland GJH. The Therapy Process Observational Coding System: Group cohesion scale in youth anxiety treatment: Psychometric properties. J Clin Psychol 2023. [PMID: 36799300 DOI: 10.1002/jclp.23496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND There are no well-established measures of group cohesion, defined as the collaborative bond between group members, in group cognitive behavioral therapy (GCBT) with youth. We therefore examined the Therapy Process Observational Coding System for Child Psychotherapy-Group Cohesion Scale (TPOCS-GC), which has previously only been used with adult samples, in a youth sample. METHODS Observers coded 32 sessions from 16 groups with 83 youth aged 8 to 15 years (90.7% European White). Youth had anxiety disorders and received manualized GCBT in community clinics. We examined psychometric properties of the TPOCS-GC and its' construct validity in terms of relations with pretreatment variables, alliance and fidelity during treatment, and post-treatment variables. Group cohesion was measured twice during treatment (early and late). RESULTS The TPOCS-GC was internally consistent (α = 0.72) and was reliably coded (M ICC = 0.61). Higher clinical severity at pretreatment predicted lower early group cohesion. Higher youth age, higher clinical severity at pretreatment, and higher youth-rated early alliance predicted lower late group cohesion. Higher therapist-rated early alliance predicted higher early group cohesion. Higher therapist-rated late alliance predicted higher late group cohesion. Higher late group cohesion predicted lower clinical severity and higher client treatment satisfaction at post-treatment. Early group cohesion did not predict any post-treatment variables. CONCLUSIONS A four-item version of the TPOCS-GC can be reliably used in youth GCBT. The TPOCS-GC is distinct from, but associated with, multiple clinical variables.
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Affiliation(s)
| | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Wendy K Silverman
- Child Study Center, School of Medicine, Yale University, New Haven, USA
| | - Jon F Bjaastad
- Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, USA
| | - Gro Janne H Wergeland
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
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4
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Martinez RG, van Dyk IS, Kroll JL, Emerson ND, Bursch B. Recommendations for building telemental health relationships with youth: A systematic review and resource for clinicians. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:349-362. [PMID: 36248612 PMCID: PMC9562612 DOI: 10.1080/23794925.2021.1970050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Ruben G. Martinez
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Ilana Seager van Dyk
- Department of Social & Behavioral Science, Yale School of Public Health, New Haven, CT
| | - Juliet L. Kroll
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TC
| | - Natacha D. Emerson
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA
| | - Brenda Bursch
- Department of Psychiatry & Biobehavioral Sciences, UCLA Jane & Terry Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA,Department of Pediatrics, UCLA David Geffen School of Medicine, Los Angeles, CA
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5
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Lau N, Colt SF, Waldbaum S, O'Daffer A, Fladeboe K, Yi-Frazier JP, McCauley E, Rosenberg AR. Telemental Health For Youth With Chronic Illnesses: Systematic Review. JMIR Ment Health 2021; 8:e30098. [PMID: 34448724 PMCID: PMC8459754 DOI: 10.2196/30098] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Children, adolescents, and young adults with chronic conditions experience difficulties coping with disease-related stressors, comorbid mental health problems, and decreased quality of life. The COVID-19 pandemic has led to a global mental health crisis, and telemental health has necessarily displaced in-person care. However, it remains unknown whether such remote interventions are feasible or efficacious. We aimed to fill this research-practice gap. OBJECTIVE In this systematic review, we present a synthesis of studies examining the feasibility and efficacy of telemental health interventions for youth aged ≤25 years with chronic illnesses. METHODS PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched from 2008 to 2020. We included experimental, quasiexperimental, and observational studies of telemental health interventions designed for children, adolescents, and young adults aged ≤25 years with chronic illnesses, in which feasibility or efficacy outcomes were measured. Only English-language publications in peer-reviewed journals were included. We excluded studies of interventions for caregivers or health care providers, mental health problems not in the context of a chronic illness, disease and medication management, and prevention programs for healthy individuals. RESULTS We screened 2154 unique study records and 109 relevant full-text articles. Twelve studies met the inclusion criteria, and they represented seven unique telemental health interventions. Five of the studies included feasibility outcomes and seven included efficacy outcomes. All but two studies were pilot studies with relatively small sample sizes. Most interventions were based on cognitive behavioral therapy and problem-solving therapy. The subset of studies examining intervention feasibility concluded that telemental health interventions were appropriate, acceptable, and satisfactory to patients and their parents. Technology did not create barriers in access to care. For the subset of efficacy studies, evidence in support of the efficacy of telemental health was mixed. Significant heterogeneity in treatment type, medical diagnoses, and outcomes precluded a meta-analysis. CONCLUSIONS The state of the science for telemental health interventions designed for youth with chronic illnesses is in a nascent stage. Early evidence supports the feasibility of telehealth-based delivery of traditional in-person interventions. Few studies have assessed efficacy, and current findings are mixed. Future research should continue to evaluate whether telemental health may serve as a sustainable alternative to in-person care after the COVID pandemic.
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Affiliation(s)
- Nancy Lau
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, United States
| | - Susannah F Colt
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Shayna Waldbaum
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Alison O'Daffer
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Kaitlyn Fladeboe
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
| | - Joyce P Yi-Frazier
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
| | - Elizabeth McCauley
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, United States
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, United States
| | - Abby R Rosenberg
- Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States
- Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, United States
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, United States
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6
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Flannery H, Portnoy S, Daniildi X, Kambakara Gedara C, Korchak G, Lambert D, McParland J, Payne L, Salvo T, Valentino C, Christie D. Keeping young people connected during COVID-19: the role of online groups. Arch Dis Child 2021; 106:739-744. [PMID: 33597184 DOI: 10.1136/archdischild-2020-320222] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/04/2021] [Accepted: 02/07/2021] [Indexed: 12/30/2022]
Abstract
The COVID-19 pandemic has had a profound impact on young people, disrupting education, routines, hobbies and peer interactions and there is concern for longer term effects on physical and mental health outcomes. Young people living with chronic health conditions face additional challenges including reduced or no face-to-face contact with medical teams, shielding and the increased stressors of being in 'at-risk' groups and social isolation. In a climate of social isolation and disconnectedness, online groups could provide a method of delivering healthcare and support that strengthens social connectedness and reduces isolation. Despite the technology being available, uptake and evidence for online groups is limited. This article shares learnings from a paediatric and adolescent psychology service delivering online groups for young people with chronic health conditions and their healthcare teams. Ideas for how to transfer group process to online platforms are considered, with examples and tips. With sufficient staffing, preparation, thought, creativity and innovation, it is possible for face-to-face groups to successfully be offered online. Caution should be exercised trying to run online groups without these provisions in place, as the safety, comfort and experience of young people could be jeopardised. Further research is needed to better understand group processes online and to consider what is lost and what is gained when comparing online to face-to-face groups.
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Affiliation(s)
- Halina Flannery
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Sara Portnoy
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Xeni Daniildi
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Chandrika Kambakara Gedara
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Gina Korchak
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Danielle Lambert
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - James McParland
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Lara Payne
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Tania Salvo
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Charlotte Valentino
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
| | - Deborah Christie
- Child and Adolescent Psychology Service, University College London Hospitals NHS Foundation Trust, London, UK
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7
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Abstract
Although telepsychiatry is not new, the COVID-19 pandemic has dramatically boosted and legitimized it, especially in the field of group therapy. Group therapists have been forced to move online without enough training in leading online groups. Online groups are not the same as meeting in person and present specific obstacles and challenges that should either be compensated for or acknowledged as losses. In this article, the author summarizes these obstacles, identifying factors in group therapy, such as body-to-body interaction, that are absent online and suggesting ways to compensate for other differences, such as the therapist's reduced control over the setting. Surprisingly, some group members may benefit from online groups more than from in-person ones, but the online format is not for everyone. Research on online therapy has already shown this format's effectiveness, and the therapeutic alliance that is positively correlated with outcome seems to be achievable online as well. However, more research is needed, especially on cohesion in online groups, which seems to develop slower online.
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Affiliation(s)
- Haim Weinberg
- Sacramento Center for Psychotherapy, Sacramento, California
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8
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Hossain SN, Jaglal SB, Shepherd J, Perrier L, Tomasone JR, Sweet SN, Luong D, Allin S, Nelson MLA, Guilcher SJT, Munce SEP. Web-Based Peer Support Interventions for Adults Living With Chronic Conditions: Scoping Review. JMIR Rehabil Assist Technol 2021; 8:e14321. [PMID: 34032572 PMCID: PMC8188320 DOI: 10.2196/14321] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/27/2020] [Accepted: 04/17/2021] [Indexed: 12/15/2022] Open
Abstract
Background Globally, 1 in 3 adults live with multiple chronic conditions. Thus, effective interventions are needed to prevent and manage these chronic conditions and to reduce the associated health care costs. Teaching effective self-management practices to people with chronic diseases is one strategy to address the burden of chronic conditions. With the increasing availability of and access to the internet, the implementation of web-based peer support programs has become increasingly common. Objective The purpose of this scoping review is to synthesize existing literature and key characteristics of web-based peer support programs for persons with chronic conditions. Methods This scoping review follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) extension for scoping reviews guidelines. Studies were identified by searching MEDLINE, CINAHL, Embase, PsycINFO, and the Physiotherapy Evidence Database. Chronic diseases identified by the Public Health Agency of Canada were included. Our review was limited to peer support interventions delivered on the web. Peers providing support had to have the chronic condition that they were providing support for. The information abstracted included the year of publication, country of study, purpose of the study, participant population, key characteristics of the intervention, outcome measures, and results. Results After duplicates were removed, 12,641 articles were screened. Data abstraction was completed for 41 articles. There was a lack of participant diversity in the included studies, specifically with respect to the conditions studied. There was a lack of studies with older participants aged ≥70 years. There was inconsistency in how the interventions were described in terms of the duration and frequency of the interventions. Informational, emotional, and appraisal support were implemented in the studied interventions. Few studies used a randomized controlled trial design. A total of 4 of the 6 randomized controlled trials reported positive and significant results, including decreased emotional distress and increased health service navigation, self-efficacy, social participation, and constructive attitudes and approaches. Among the qualitative studies included in this review, there were several positive experiences related to participating in a web-based peer support intervention, including increased compassion and improved attitudes toward the individual’s chronic condition, access to information, and empowerment. Conclusions There is limited recent, high-level evidence on web-based peer support interventions. Where evidence exists, significant improvements in social participation, self-efficacy, and health-directed activity were demonstrated. Some studies incorporated a theoretical framework, and all forms of peer support—emotional, informational, and appraisal support—were identified in the studies included in this review. We recommend further research on web-based peer support in more diverse patient groups (eg, for older adults and chronic conditions outside of cancer, cardiovascular disease, and HIV or AIDS). Key gaps in the area of web-based peer support will serve to inform the development and implementation of future programs.
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Affiliation(s)
- Saima N Hossain
- Toronto Rehabilitation Insititute, University Health Network, Toronto, ON, Canada
| | - Susan B Jaglal
- Toronto Rehabilitation Insititute, University Health Network, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - John Shepherd
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Laure Perrier
- University of Toronto Libraries, University of Toronto, Toronto, ON, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Shane N Sweet
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Dorothy Luong
- Toronto Rehabilitation Insititute, University Health Network, Toronto, ON, Canada
| | - Sonya Allin
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Michelle L A Nelson
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Sara J T Guilcher
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Sarah E P Munce
- Toronto Rehabilitation Institute - Rumsey Centre, University Health Network, Toronto, ON, Canada
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9
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Sansom-Daly UM, Wakefield CE, Ellis SJ, McGill BC, Donoghoe MW, Butow P, Bryant RA, Sawyer SM, Patterson P, Anazodo A, Plaster M, Thompson K, Holland L, Osborn M, Maguire F, O’Dwyer C, De Abreu Lourenco R, Cohn RJ. Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial. Cancers (Basel) 2021; 13:2460. [PMID: 34070134 PMCID: PMC8158368 DOI: 10.3390/cancers13102460] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/20/2022] Open
Abstract
Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.
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Affiliation(s)
- Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia;
| | | | - Susan M. Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Royal Children’s Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia;
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Megan Plaster
- Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia;
| | - Kate Thompson
- Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lucy Holland
- Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia;
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Michael Osborn
- Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia;
| | - Fiona Maguire
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Catherine O’Dwyer
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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10
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McLoone J, Wakefield CE, Taylor N, Johnston K, Sansom-Daly UM, Cohen J, O'Brien TA, Cohn RJ, Signorelli C. The COVID-19 pandemic: Distance-delivered care for childhood cancer survivors. Pediatr Blood Cancer 2020; 67:e28715. [PMID: 32970366 DOI: 10.1002/pbc.28715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Jordana McLoone
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Natalie Taylor
- Cancer Research Division, Cancer Council New South Wales, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Karen Johnston
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Ursula M Sansom-Daly
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.,Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Jennifer Cohen
- School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia.,CanTeen, Sydney, New South Wales, Australia
| | - Tracey A O'Brien
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
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11
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Sansom‐Daly UM, Bradford N. Grappling with the "human" problem hiding behind the technology: Telehealth during and beyond COVID-19. Psychooncology 2020; 29:1404-1408. [PMID: 32779776 PMCID: PMC7361303 DOI: 10.1002/pon.5462] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ursula M. Sansom‐Daly
- School of Women's and Children's Health, University of New South Wales (UNSW) Medicine, UNSW SydneyKensingtonNew South WalesAustralia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's HospitalRandwickNew South WalesAustralia
- Sydney Youth Cancer Service, Prince of Wales HospitalRandwickNew South WalesAustralia
| | - Natalie Bradford
- Centre for Healthcare Transformation and School of Nursing at Centre for Children's Health Research, Centre for Children's Health ResearchBrisbaneQueenslandAustralia
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12
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Lleras de Frutos M, Medina JC, Vives J, Casellas-Grau A, Marzo JL, Borràs JM, Ochoa-Arnedo C. Video conference vs face-to-face group psychotherapy for distressed cancer survivors: A randomized controlled trial. Psychooncology 2020; 29:1995-2003. [PMID: 32618395 DOI: 10.1002/pon.5457] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study assesses the effectiveness of face-to-face group positive psychotherapy for cancer survivors (PPC) compared to its online adaptation, online group positive psychotherapy for cancer survivors (OPPC), which is held via videoconference. A two-arm, pragmatic randomized controlled trial was conducted to examine the effects of both interventions on emotional distress, post-traumatic stress symptoms (PTSS), and post-traumatic growth (PTG) among cancer survivors and analyze attrition to treatment. METHODS Adult women with a range of cancer diagnoses were invited to participate if they experienced emotional distress at the end of their primary oncological treatment. Emotional distress, PTSS, and PTG were assessed at baseline, immediately after treatment, and 3 months after treatment. Intention-to-treat analyses were carried out using general linear mixed models to test the effect of the interventions overtime. Logistic regressions were performed to test differential adherence to treatment and retention to follow-up. RESULTS A total of 269 individuals participated. The observed treatment effect was significant in both modalities, PPC and OPPC. Emotional distress (b = -2.24, 95% confidence interval [CI] = -3.15 to -1.33) and PTSS (b = -3.25, 95% CI = -4.97 to -1.53) decreased significantly over time, and PTG (b = 3.08, 95% CI = 0.38-5.78) increased significantly. Treatment gains were sustained across outcomes and over time. Analyses revealed no significant differences between modalities of treatment, after adjusting for baseline differences, finding that OPPC is as effective and engaging as PPC. CONCLUSIONS The OPPC treatment was found to be effective and engaging for female cancer early survivors. These results open the door for psycho-oncology interventions via videoconference, which are likely to lead to greater accessibility and availability of psychotherapy.
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Affiliation(s)
- María Lleras de Frutos
- Psycho-Oncology Department and ICOnnecta't e-Health Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.,Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain
| | - Joan Carles Medina
- Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Psychology and Educational Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Jaume Vives
- Department of Psychobiology and Methodology of Health Sciences and Sport Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Casellas-Grau
- Psychosocial Observatory in Cancer, Institut Català d'Oncologia. L'Hospitalet de Llobregat, Barcelona, Spain.,Psychology Department, Faculty of Education, Translation, and Human Sciences, Universitat de Vic - Universitat Central de Catalunya, Vic, Spain
| | | | - Josep M Borràs
- Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Science, Universitat de Barcelona, Barcelona, Spain
| | - Cristian Ochoa-Arnedo
- Psycho-Oncology Department and ICOnnecta't e-Health Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.,Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain.,Institut d'Investigació Biomèdica de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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13
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Lang MJ, Dort JC, Stephen J, Lamont L, Giese-Davis J. Narrative-Informed, Emotion-Focused Psychotherapy in Synchronous, Online Chat Groups for Adolescents and Young Adults with Cancer: A Proof-of-Concept Study. J Adolesc Young Adult Oncol 2020; 9:676-682. [PMID: 32614264 PMCID: PMC7757545 DOI: 10.1089/jayao.2020.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Few, scalable, evidence-based psychosocial interventions exist for adolescent and young adult cancer survivors (AYAs, 18–39 years old). Using an existing, facilitated, online synchronous chat group-plus-education model (OSG+E), we replaced their educational workbook with an AYA-created film to stimulate an age-specific, emotion-focused group discussion (OSG+V). This randomized proof-of-concept trial compared the two models' content suitability, group processes, and feasibility over 9 months in 34 male and female AYAs with a range of cancers. AYAs rated the OSG + V model more suitable, cohesive, and as having higher levels of important group processes than the OSG+E. A larger randomized trial is feasible for this AYA-appropriate, emotion-focused OSG + V model.
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Affiliation(s)
- Michael J Lang
- Faculty of Nursing and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joseph C Dort
- Departments of Surgery, Oncology, and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Joanne Stephen
- Department of Psychosocial Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Lisa Lamont
- Department of Psychosocial Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Janine Giese-Davis
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, and Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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14
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Payne L, Flannery H, Kambakara Gedara C, Daniilidi X, Hitchcock M, Lambert D, Taylor C, Christie D. Business as usual? Psychological support at a distance. Clin Child Psychol Psychiatry 2020; 25:672-686. [PMID: 32594756 PMCID: PMC7370649 DOI: 10.1177/1359104520937378] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The impact of COVID-19 has challenged the long accepted 'norm' in delivery of psychological therapy. Public policies designed to reduce transmission have made it extremely difficult to meet with service-users safely in the traditional face-to-face context. E-therapies have existed in theory and practice since technological progress has made them possible. They can offer a host of advantages over face-to-face equivalents, including improved access, greater flexibility for service-users and professionals, and cost savings. However, despite the emerging evidence and anticipated positive value, implementation has been slower than anticipated. Concerns have been raised by service-users, clinicians, and public health organisations, identifying significant barriers to the wide spread use of e-therapies. In the current climate, many clinicians are offering e-therapies for the first time, without prior arrangement or training, as the only viable option to continue to support their clients. This paper offers a clinically relevant review of the e-therapies literature, including effectiveness and acceptability dilemmas and challenges that need to be addressed to support the safe use and growth of e-therapies in psychology services. Further research is needed to better understand what might be lost and what gained in comparison to face-to-face therapy, and for which client groups and settings it might be most effective.
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Affiliation(s)
- Lara Payne
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
| | - Halina Flannery
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
| | | | - Xeni Daniilidi
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
| | - Megan Hitchcock
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
| | - Danielle Lambert
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
| | - Charlotte Taylor
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
| | - Deborah Christie
- Child and Adolescent Psychology Service, University College London Hospital, London, UK
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15
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Hall BC, Short VM, Giberson S, Howe-Martin L. A Cognitive Behavioral Therapy Group for Adolescent and Young Adult Cancer Patients: A Review of a Pilot Program. J Adolesc Young Adult Oncol 2020; 9:422-425. [DOI: 10.1089/jayao.2019.0104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Brittany C. Hall
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
- Fort Worth Adolescent Young Adult Oncology Coalition, Fort Worth, Texas, USA
| | - Victoria M. Short
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
- Department of Psychology, Texas Christian University, Fort Worth, Texas, USA
| | - Scott Giberson
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
- Department of Psychology, Texas Christian University, Fort Worth, Texas, USA
| | - Laura Howe-Martin
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
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16
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Cherian R, Le G, Whall J, Gomez S, Sarkar U. Content shared on social media for national cancer survivors day 2018. PLoS One 2020; 15:e0226194. [PMID: 31940384 PMCID: PMC6961846 DOI: 10.1371/journal.pone.0226194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 11/18/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies estimate that the number of cancer survivors will double by 2050 due to improvements in diagnostic accuracy and treatment efficacy. Despite the growing population of cancer survivors, there is a paucity of research regarding how these individuals experience the transition from active treatment to long-term surveillance. While research has explored this transition from more organized venues, such as support groups for cancer survivors, this paper explores the discourses surrounding cancer survivorship on social media, paying particular attention to how individuals who identify as cancer survivors represent their experience. METHODS We identified social media posts relating to cancer survivorship on Twitter and Instagram in early June 2018, in order to coincide with National Cancer Survivorship Day on June 3, 2018. We used nine pre-selected hashtags to identify content. For each hashtag, we manually collected the 150 most recent posts from Twitter and the 100 most recent plus the top 9 posts from Instagram. Our preliminary sample included 1172 posts; after eliminating posts from one hashtag due to irrelevance, we were left with 1063 posts. We randomly sampled 200 of these to create a subset for analysis; after review for irrelevant posts, 193 posts remained for analysis (118 from Instagram and 75 from Twitter). We utilized a grounded theory approach to analyze the posts, first open-coding a subset to develop a codebook, then applying the codebook to the rest of the sample and finally memo writing to develop themes. RESULTS Overall, there is substantial difference in the tone and thematic content between Instagram and Twitter posts, Instagram takes on a more narrative form that represents journeys through cancer treatment and subsequent survivorship, whereas Twitter is more factual, leaning towards advocacy, awareness and fundraising. In terms of content type, 120 posts (62%) of the sample were images, of which 42 (35%) were images of the individual posting and 28 (23%) were images of patients posted by family or friends. Of the remaining images, 14 (12%) were of support groups and 7 (6%) were of family or friends. We identified four salient themes through analysis of the social media posts from Twitter and Instagram: social support, celebrating milestones and honoring survivors, expressing identity, and renewal vs. rebirth. DISCUSSION We observed a marked relationship between physical appearance, functional status and survivorship. Additionally, our findings suggest the importance of social support for cancer patients and survivors as well as the role social media can pay in identity formation. CONCLUSION Our findings suggest that individuals who identify as survivors on social media define their identity fluidly, incorporating elements of physical, emotional and psychological health as well as autonomy.
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Affiliation(s)
- Roy Cherian
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - Gem Le
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
| | - James Whall
- California Northstate University College of Medicine, Elk Grove, California, United States of America
| | - Scarlett Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
| | - Urmimala Sarkar
- Department of Medicine, Division of General Internal Medicine University of California, San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California, United States of America
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17
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Osborn M, Johnson R, Thompson K, Anazodo A, Albritton K, Ferrari A, Stark D. Models of care for adolescent and young adult cancer programs. Pediatr Blood Cancer 2019; 66:e27991. [PMID: 31524328 DOI: 10.1002/pbc.27991] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 12/12/2022]
Abstract
This review draws on the experience of adolescent and young adult (AYA) cancer clinicians from Australia, the United States, and the United Kingdom to summarize common aspects of models of care implemented in their countries. The principles underpinning these models include patient- and family-focused care informed by an understanding of normal AYA development, enhancing existing adult or pediatric cancer services to meet the needs of AYA, and promoting collaboration between pediatric and adult oncologists. Common elements of AYA cancer care include establishing an AYA multidisciplinary team that integrates medical and psychosocial care, efforts to centralize complex care, providing access and equity for all AYA, promoting clinical trials, and helping facilitate transition to healthy survivorship. Several organizational approaches are described, noting that local program development depends on resources, infrastructure, and assessment of unmet needs within the region. The development of national networks provides opportunities for shared learning and approaches to evaluation.
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Affiliation(s)
- Michael Osborn
- Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Rebecca Johnson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Adolescent and Young Adult Oncology Program, Mary Bridge Children's Health Center/MultiCare Health System, Tacoma, Washington
| | - Kate Thompson
- OnTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Karen Albritton
- Adolescent and Young Adult Oncology, Cook Children's Medical Center, Fort Worth, Texas
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Daniel Stark
- The Leeds Institute of Cancer and Pathology, Leeds Institute of Oncology and St James's University Hospital, Leeds, UK
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18
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Psychological support for patients with cancer: evidence review and suggestions for future directions. Curr Opin Support Palliat Care 2019; 12:276-292. [PMID: 30074924 DOI: 10.1097/spc.0000000000000360] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Psychological distress and mental health comorbidity are common in cancer. Various therapeutic frameworks have been used for interventions to improve psychological wellbeing and quality of life in cancer patients with mixed results. This article reviews contributions to that literature published since January 2017. RECENT FINDINGS The majority of new psychological intervention research in cancer has used cognitive behavioural therapy (CBT) or mindfulness-based interventions. CBT has been considered a gold-standard intervention and recent evidence justifies continuation of this. Recent reviews call into question the validity of evidence for mindfulness-based interventions. A smaller number of trials using acceptance and commitment therapy, meta-cognitive therapy, dignity therapy and coaching have emerged, and whereas findings are promising, additional fully powered trials are required. Weaker evidence exists for counselling, support-based and narrative therapy interventions. SUMMARY Efficacious, timely and acceptable psychological interventions are a necessary component of comprehensive cancer care. There is some way to go before the evidence conclusively points towards which interventions work for which cancer groups and for which specific outcomes. Methodological limitations must be addressed in future trials; at the forefront remains the need for fully powered, head-to-head comparison trials.
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19
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Aubin S, Rosberger Z, Hafez N, Noory MR, Perez S, Lehmann S, Batist G, Kavan P. Cancer!? I Don't Have Time for That: Impact of a Psychosocial Intervention for Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:172-189. [DOI: 10.1089/jayao.2017.0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
| | | | - Nada Hafez
- Jewish General Hospital, Montreal, Canada
| | | | | | | | | | - Petr Kavan
- Jewish General Hospital, Montreal, Canada
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20
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Sansom‐Daly UM, Wakefield CE, Bryant RA, Patterson P, Anazodo A, Butow P, Sawyer SM, McGill BC, Evans HE, Cohn RJ. Feasibility, acceptability, and safety of the Recapture Life videoconferencing intervention for adolescent and young adult cancer survivors. Psychooncology 2018; 28:284-292. [DOI: 10.1002/pon.4938] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/05/2018] [Accepted: 11/04/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Ursula M. Sansom‐Daly
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Claire E. Wakefield
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | | | - Pandora Patterson
- Research, Evaluation and Social Policy UnitCanTeen Newtown Australia
- Cancer Nursing Research Unit, Sydney Nursing SchoolThe University of Sydney Sydney Australia
| | - Antoinette Anazodo
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making (CeMPED), School of PsychologyUniversity of Sydney Sydney Australia
| | - Susan M. Sawyer
- Department of PaediatricsUniversity of Melbourne Melbourne Australia
- Murdoch Children's Research Institute Melbourne Australia
- Royal Children's Hospital Centre for Adolescent Health Melbourne Australia
| | - Brittany C. McGill
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Holly E. Evans
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Richard J. Cohn
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
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21
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Kaal SE, Husson O, van Dartel F, Hermans K, Jansen R, Manten-Horst E, Servaes P, van de Belt TH, Engelen LJ, Prins JB, Verberne S, van der Graaf WT. Online support community for adolescents and young adults (AYAs) with cancer: user statistics, evaluation, and content analysis. Patient Prefer Adherence 2018; 12:2615-2622. [PMID: 30584285 PMCID: PMC6287522 DOI: 10.2147/ppa.s171892] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Peer support is an important unmet need among adolescent and young adult (AYA) cancer patients. This study was conducted to describe the use and evaluation of a Dutch secure online support community for AYA diagnosed with cancer between 18 and 35 years. METHODS User statistics were collected with Google analytics. Community members were asked to complete questionnaires on the usefulness of the community. A content analysis using Linguistic Inquiry and Word Count was conducted. RESULTS Between 2010 and 2017, the community received 433 AYA members (71% female; mean age at diagnosis 25.7 years; 52 Dutch hospitals represented). The mean time since diagnosis when subscribing to the community was 2.7 years (SD 4.4). Questionnaire data among 30 AYA community members indicated that the use of the community resulted in acknowledgment and advice regarding problems (56%) and the feeling of being supported (63%). Almost half of the respondents felt less lonely, 78% experienced recognition in stories of other AYA. Anonymized content analysis (n=14) showed that the majority of the online discussions encompassed emotional and cognitive expressions, and emotional support. CONCLUSION The secure Dutch online AYA community can help AYA cancer patients to express feelings, exchange information, address peer support, and has been found helpful in coping with cancer. As AYA cancer patients often lack the option of meeting each other in person, the AYA community is helpful in establishing peer support. Its use would benefit from promotion by health care professionals.
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Affiliation(s)
- Suzanne Ej Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Olga Husson
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
- Division of Clinical Studies, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK,
| | - Fleur van Dartel
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Karin Hermans
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
| | - Petra Servaes
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tom H van de Belt
- Radboud REshape and Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lucien Jlpg Engelen
- Radboud REshape and Innovation Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith B Prins
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Suzan Verberne
- Leiden Institute for Advanced Computer Science, Leiden University, Leiden, the Netherlands
| | - Winette Ta van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands,
- Dutch AYA "Young and Cancer" Platform, AYA Platform Radboudumc, Radboud University Medical Center, Nijmegen, the Netherlands,
- Division of Clinical Studies, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK,
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22
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Sison J, Tran H, Margol A, Tiwari N, Garcia KM, Cotter J, Kiehna E, Olch AJ, Wong K. Palliative Care Options for a Young Adult Patient with a Diffuse Intrinsic Pontine Glioma. Cureus 2017; 9:e1580. [PMID: 29057192 PMCID: PMC5647135 DOI: 10.7759/cureus.1580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Diffuse intrinsic pontine gliomas (DIPGs) are rare but devastating brain tumors that occur primarily in children. These gliomas have poor prognoses and present options focus on palliation of symptoms and prolongation of life. Here, we present a case of a 16-year-old female diagnosed with a DIPG whose age group has been mostly left out of discussions regarding psychosocial support options. This report is meant to start a conversation about the different support options available at our institution that have shown promising results in the literature for palliative care applications. These options can include camps for patients with brain tumors, psychological counseling, the Ronald McDonald House, and other psychosocial programs. Many of these programs can be tailored to meet the specific needs of adolescent and young adult (AYA) patients and will hopefully be integrated into a comprehensive palliative care regimen in future studies.
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Affiliation(s)
| | - Hung Tran
- Children's Center for Cancer and Blood Diseases, Children's Hospital of Los Angeles
| | - Ashley Margol
- Children's Center for Cancer and Blood Diseases, Children's Hospital of Los Angeles
| | - Nishant Tiwari
- Pathology and Laboratory Medicine, Children's Hospital of Los Angeles
| | - Karla M Garcia
- Clinical Social Work, Children's Hospital of Los Angeles
| | - Jennifer Cotter
- Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, Ca
| | - Erin Kiehna
- Department of Neurosurgery, Children's Hospital of Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, Ca
| | - Arthur J Olch
- Department of Radiation Oncology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Kenneth Wong
- Department of Radiation Oncology, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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