Abstract
BackgroundA subgroup of adolescent and young adult (AYA) survivors of cancer during adolescence report high levels of psychological distress. To date, evidence-based psychological interventions tailored to the cancer-related concerns experienced by this population are lacking. The present study aimed to (1) examine the feasibility and preliminary efficacy of an individualized cognitive behavioral therapy (CBT) intervention for AYA survivors of cancer during adolescence; and (2) identify and conceptualize cancer-related concerns as well as maintaining factors using cognitive-behavioral theory.MethodsA single-arm trial, whereby AYA survivors of cancer during adolescence (aged 17–25 years) were provided individualized face-to-face CBT at a maximum of 15 sessions. Clinical outcomes were assessed at baseline, post-intervention, and three-month follow-up. Intervention uptake, retention, intervention delivery, and reliable change index scores were examined. An embedded qualitative study consisted of two unstructured interviews with each participant pre-intervention. Along with individual behavioral case formulations developed to guide the intervention, interview data was analyzed to identify and conceptualize cancer-related concerns and potential maintaining factors.ResultsTen out of 213 potential participants invited into the study were included, resulting in an overall participation rate of 4.7%. Nine participants completed the intervention, with respectively seven and eight participants completing the post-intervention and three month follow-up assessment. The majority of reported cancer-related concerns and maintaining factors were conceptualized into four themes: social avoidance, fear of emotions and bodily symptoms, imbalance in activity, and worry and rumination.ConclusionsGiven significant recruitment difficulties, further research is required to examine barriers to help-seeking in the AYA cancer survivor population. However, the conceptualization of cancer-related concerns and maintaining factors experienced by the population may represent an important first step in the development of psychological support tailored toward AYA cancer survivors’ unique needs.
Highlights
Adolescent and young adult (AYA) survivors of cancer diagnosed during adolescence report numerous stressors relating to cancer diagnosis, treatment, and survivorship (Abrams, Hazen & Penson, 2007; Lehmann et al, 2014)
Some evidence has suggested lower levels of psychological distress compared to population norms (Larsson, Mattsson & Von Essen, 2010), research has consistently identified a subgroup of AYA survivors of cancer during adolescence who report an elevated level of long-term psychological distress (De Laage et al, 2016; Husson et al, 2017)
One participant self-reported being diagnosed with Myelodysplastic syndrome (MDS) which contrasted with registry information
Summary
Adolescent and young adult (AYA) survivors of cancer diagnosed during adolescence report numerous stressors relating to cancer diagnosis, treatment, and survivorship (Abrams, Hazen & Penson, 2007; Lehmann et al, 2014). Studies have demonstrated that AYA survivors of cancer during adolescence report elevated levels of psychological distress in comparison to matched cancer-free controls (Seitz et al, 2010), those diagnosed during childhood (Kazak et al, 2010) and adulthood respectively (Lang et al, 2018). The present study aimed to (1) examine the feasibility and preliminary efficacy of an individualized cognitive behavioral therapy (CBT) intervention for AYA survivors of cancer during adolescence; and (2) identify and conceptualize cancer-related concerns as well as maintaining factors using cognitivebehavioral theory. Along with individual behavioral case formulations developed to guide the intervention, interview data was analyzed to identify and conceptualize cancer-related concerns and potential maintaining factors. The conceptualization of cancer-related concerns and maintaining factors experienced by the population may represent an important first step in the development of psychological support tailored toward AYA cancer survivors’ unique needs
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