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.