Shepherd, et. al., 2006

The intervention was CBT offered as telepsychology. A clinical psychologist provided one-hour brief CBT to rural oncology patients in Australia via videoconferencing. These brief CBT sessions were held weekly or bi-weekly for one to six sessions, depending on the patient’s ―Distress Thermometer‖ rating and clinical judgment of oncology staff caring for the patient.

After formal assessment, a treatment plan was individualized to include cognitive-behavioral techniques, such as problem solving, activity scheduling, and controlled breathing. Each patient came to the rural clinic for the intervention. A staff member was in attendance with patient throughout the videoconference session.

Longitudinal pilot study. 24 Australian rural oncology patients scoring 7+/10 on distress thermometer tool or clinical identification by staff caring for the patient received the intervention.

All patients in this study received intervention. Questionnaires offered at: pretreatment, post-treatment, and one month follow up.

Pre-treatment questionnaire included: demographic information, previous treatment by a psychologist, current use of psychotropic medications, time of initial diagnosis, and current cancer treatment prescribed.

HADS FACT-G (QOL)

Pt satisfaction asking about pt attitude toward telepsychology experience

Needed 165 participants to make power levels: analyses of effect size done with reported p values p=0.01. Patient anxiety levels over intervention period decreased significantly with large effect size sustained over 1 month. Anxiety scores (part of HADS) F=5.55, p+0.01 and n2=partial squared (magnitude of association) = 0.33.

The traditional ―standard ―dose‖ of CBT is group therapy setting of 6- 8 weeks (9-12 hrs) of therapy. Even with this study’s ―inadequate‖ dose of therapy, the individual, brief CBT made a significant decrease in anxiety levels.

A significant flaw of this study is lack of control group and limited sample size. This is a small pilot study with numerous confounding variables (type of psychotropic medication taken, type and stage of cancer, time since diagnosis of cancer).

A minor flaw was the presence of staff member during videoconference as this may have inhibited patient responses to therapy.