Poster Presentation NSW State Cancer Conference 2023

iCanBlend: Blended psychological therapy for the treatment of anxiety and depression in adult patients with an experience of cancer. (#256)

Kelly F Nunes-Zlotkowski 1 2 , Heather L Shepherd 1 3 , Lisa Beatty 1 4 , Phyllis Butow 1 2 , Joanne Shaw 1 2
  1. School of Psychology, Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, New South Wales, Australia
  2. School of Psychology, Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, New South Wales, Australia
  3. Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, New South Wales, Australia
  4. Clinical Psychology, College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia

Background: Lifetime prevalence estimates of major depression (18%) and anxiety (24%) in patients with cancer1 are higher than those in the general population2,3. Despite availability of effective cancer-specific interventions for depression and anxiety, treatment uptake is low4,5. Reasons for low uptake include workforce issues and geographic barriers to access. Blending online and face-to-face psychological therapy may increase acceptability of and engagement with treatment by patients being treated for cancer and by service providers. Blended psychological therapy combines patient-driven, online therapy with therapist-facilitated sessions6-8, providing an opportunity for improving access to treatment, treatment uptake and adherence, treatment maintenance and therapy effects9-11. Research regarding non-cancer mental health interventions supports the efficacy and cost-effectiveness of blended therapy and provides evidence for different models of blended therapy. However, there is limited evidence confirming the acceptability and feasibility of blended therapy in cancer.

Aim: This study aimed to explore psycho-oncology stakeholders (service managers, psychologists) views on the feasibility and acceptability of blended therapy models and barriers and facilitators to implementation into routine psycho-oncology care in Australia.

Method: Participants were recruited from psycho-oncology services across Australia and included Psychologists working clinically with cancer patients and psycho-oncology service managers We conducted qualitative, semi-structured, telephone interviews to explore feasibility and acceptability of different blended therapy models and to identify barriers and facilitators to implementation of blended therapy in psycho-oncology. Interviews were analysed qualitatively using a Framework Analysis12 approach.

Results: Twenty professionals (psychologists, n=15; service managers, n=5) participated in telephone interviews between October 2022 - May 2023. Analysis identified an overarching theme of trust and three subthemes, namely (i) flexibility & patient engagement; (ii) autonomy & patient empowerment; (iii) health system & readiness to change. Specifically, the use of digital technology by patients was perceived as both a barrier to patient engagement but also providing increased flexibility for access. Clinicians were concerned about lack of autonomy to deliver therapy but also noted blended therapy could optimise clinician time and resources. Finally, there were concerns about service over-reliance on the digital component due to funding issues.

Conclusion: Stakeholders’ views on blended therapy designs informed key aspects regarding feasibility and acceptability of blended therapy models for treating anxiety and depression in adults with cancer. Themes and subthemes identified will assist in conceptualising and developing a blended therapy model appropriate to the Australian context which will be tested by potential end-users in a subsequent study.

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