Combined Face-to-Face and Online Cognitive-Behavioral Therapy for High Distress of Colorectal Cancer Survivors: A Case Study

• Published in: Cognitive and behavioral practice 2021-02, Vol.28 (1), p.107-123
• Main Authors: Döking, Sarah, Koulil, Saskia Spillekom-van, Thewes, Belinda, Braamse, Annemarie M.J., Custers, José A.E., Prins, Judith B.
• Format: Article
• Language: English
• Subjects: case study; cognitive-behavior therapy; colorectal cancer survivors; eHealth; psychological distress
• ISSN: 1077-7229; 1878-187X
• DOI: 10.1016/j.cbpra.2020.06.008

This case study evaluates the COloRectal canceR distrEss reduCTion (CORRECT) intervention, a blended cognitive-behavioral therapy (bCBT) combining face-to-face (F2F) therapy with an interactive self-management website to reduce high distress in colorectal cancer survivors (CRCS). A cognitive-behavior therapist treated a 74-year-old male CRCS with bCBT for 4 months. At baseline, postintervention, and 7- and 14-months follow-up he filled in questionnaires assessing psychological distress (primary outcome Brief Symptom Inventory–18 [BSI-18]), anxiety, fatigue, fear of cancer recurrence, cancer-specific distress, self-efficacy, and quality of life. Reliable Change Indexes were used to analyze effects over time. Therapeutic alliance and intervention evaluation were assessed postintervention. An independent clinical psychologist performed a semi-structured interview 10 months from baseline. A detailed description shows the course of bCBT. Quantitative analyses showed improved postintervention psychological distress. Most secondary outcomes improved. Anxiety and cancer-specific distress remained improved during follow-ups. Therapeutic alliance and patient satisfaction were high. This study showed how a combined F2F and online intervention was successful in reducing distress of a cancer survivor. The treatment protocol appeared feasible and will be tested in a randomized controlled trial. •First CBT for colorectal cancer survivors aimed at distress reduction•Detailed description of tailored blended cognitive-behavioral therapy (bCBT)•Distress and other cancer-related symptoms were significantly reduced•High patient satisfaction with the therapist contact and self-management website