BACKGROUND
The demand for mental health care, particularly for depression and anxiety, is three times greater in oncology and palliative care patients compared to the general population. This population faces unique barriers making them more susceptible to mental health challenges. Various forms of psychotherapy have been deemed effective in addressing mental health challenges in this population including supportive psychotherapy, cognitive behavioural therapy, problem-based therapy, and mindfulness. However, oncology and palliative care patient's access to traditional face-to-face psychotherapy resources is limited due to compromised immune systems making frequent visits to hospitals dangerous. Additionally, patients can face hospital fatigue from numerous appointments and investigations or may live in remote areas making commutes both physically and financially taxing. The online delivery of psychotherapy is a promising solution to address these accessibility barriers. Moreover, the online delivery of psychotherapy has been proven effective in addressing depression and anxiety in other populations and may be able to be transferred to oncology and palliative care patients.
OBJECTIVE
The study will investigate the feasibility and effectiveness of online delivery of psychotherapy for oncology and palliative care patients with comorbid depression or anxiety. It is hypothesized that this program will be a viable and efficacious treatment modality compared to treatment as usual in addressing depression and anxiety symptoms in this population.
METHODS
Participants (n = 60) with depression or anxiety will be recruited from oncology and palliative care settings in Kingston, Ontario, Canada. Participants will be randomly allocated to either receive 8 weeks of online psychotherapy plus treatment as usual (treatment arm), or treatment as usual exclusively (control arm). The online psychotherapy program will incorporate cognitive behavioural therapy, mindfulness, and problem-solving skills as well as homework assignments with personalized feedback from a therapist. All online programs will be delivered through a secure online platform specifically designed for the online delivery of psychotherapy. To evaluate treatment efficacy, all participants will complete standardized symptomology questionnaires at baseline, mid-point (week 4), and post-treatment.
RESULTS
The study received ethics approval in February 2021 and began recruitment in April 2021. Participant recruitment has been conducted through social media advertisements, physical advertisements, and physician referrals. To date, there have been 11 (treatment n = 5; control n = 4; drop-out n = 2) participants recruited. Data collection is expected to conclude by December 2021, and data analysis is expected to be completed by January 2022. Linear regression (for continuous outcomes) will be conducted with interpretive qualitative methods.
CONCLUSIONS
Findings from this study can be incorporated into clinical policy and help develop more accessible mental health treatment options for oncology and palliative care patients. The asynchronous and online delivery of psychotherapy is a more accessible, scalable, and financially feasible treatment that could have major implications on the health care system.
CLINICALTRIAL
ClinicalTrials.gov NCT04664270; clinicaltrials.gov/ct2/show/NCT04664270
Developing and implementing an online psychotherapy program to address mental health challenges in oncology and palliative care patients: Protocol (Preprint)
