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Open Access Highly Accessed Study protocol

Online group-based cognitive-behavioural therapy for adolescents and young adults after cancer treatment: A multicenter randomised controlled trial of Recapture Life-AYA

Ursula M Sansom-Daly1*, Claire E Wakefield1, Richard A Bryant2, Phyllis Butow3, Susan Sawyer4, Pandora Patterson5, Antoinette Anazodo6, Kate Thompson7 and Richard J Cohn1

Author Affiliations

1 Centre for Children’s Cancer and Blood Disorders (CCC&BD), Level 1, Sydney Children’s Hospital, High Street, Randwick, NSW 2031, Australia

2 School of Psychology, University of New South Wales, Sydney, NSW, 2052, Australia

3 School of Psychology, Brennan MacCallum Building, The University of Sydney, Sydney, NSW, 2006, Australia

4 Centre for Adolescent Health, Royal Children’s Hospital, 50 Flemington Rd, Parkville, VIC, 3052, Australia

5 CanTeen, Level 11, 130 Elizabeth St, Sydney, NSW, 2000, Australia

6 Sydney Youth Cancer Service, Medical Professorial Unit, 1st Floor South Wing Edmund Blackett Building, Prince of Wales Hospital, Barker St, Randwick, NSW, 2031, Australia

7 OnTrac@PeterMac, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett Street, Melbourne, VIC, 8006, Australia

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BMC Cancer 2012, 12:339  doi:10.1186/1471-2407-12-339

Published: 3 August 2012

Abstract

Background

A cancer diagnosis is 2.9 times more likely to occur during the adolescent and young adult years than in younger children. This spike in incidence coincides with a life stage characterised by psychological vulnerability as young people strive to attain numerous, critical developmental milestones. The distress young people experience after cancer treatment seriously jeopardises their ability to move into well-functioning adulthood.

Methods/Design

This article presents the protocol of the Recapture Life study, a phase II three-arm randomised controlled trial designed to evaluate the feasibility and efficacy of a new intervention in reducing distress and improving quality of life for adolescent and young adult cancer survivors. The novel intervention, “ReCaPTure LiFe” will be compared to a both a wait-list, and a peer-support group control. Ninety young people aged 15–25 years who have completed cancer treatment in the past 1–6 months will be recruited from hospitals around Australia. Those randomised to receive Recapture Life will participate in six, weekly, 90-minute online group sessions led by a psychologist, involving peer-discussion around cognitive-behavioural coping skills (including: behavioural activation, thought challenging, communication and assertiveness skills training, problem-solving and goal-setting). Participants randomised to the peer-support group control will receive non-directive peer support delivered in an identical manner. Participants will complete psychosocial measures at baseline, post-intervention, and 12-months post-intervention. The primary outcome will be quality of life. Secondary outcomes will include depression, anxiety, stress, family functioning, coping, and cancer-related identity.

Discussion

This article reviews the empirical rationale for using group-based, online cognitive-behavioural therapy in young people after cancer treatment. The potential challenges of delivering skills-based programs in an online modality are highlighted, and the role of both peer and caregiver support in enhancing the effectiveness of this skills-based intervention is also discussed. The innovative videoconferencing delivery method Recapture Life uses has the potential to address the geographic and psychological isolation of adolescents and young adults as they move toward cancer survivorship. It is expected that teaching AYAs coping skills as they resume their normal lives after cancer may have long-term implications for their quality of life.

Trial Registration

ACTRN12610000717055

Keywords:
Adolescent and young adult; AYA; Cancer; Survivorship; Intervention study; Randomised-controlled trial; Psychological adaptation; Quality of life; Cognitive-behavioural therapy; Internet; Online