Randomised controlled trial of internet‐delivered cognitive behaviour therapy for clinical depression and/or anxiety in cancer survivors (iCanADAPT Early)

Purpose To evaluate internet‐delivered cognitive behavioural therapy (iCBT) on clinical depression and/or anxiety, distress, fear of cancer recurrence, and quality of life in cancer survivors. Methods Random assignation of 114 participants to iCBT or treatment‐as‐usual (TAU). The clinician‐supervised iCBT program (iCanADAPT Early) consisted of eight lessons over 16 weeks. Self‐report questionnaires occurred at baseline, midpoint, and posttreatment for both groups with 3‐month follow‐up for iCBT participants. A mixed modelling approach to compare groups occurred. Results iCBT was superior to TAU on all outcome measures at posttreatment. Compared with TAU, the iCBT group showed a significant decrease over time in anxiety and depression symptoms (primary outcome, Hospital Anxiety and Depression Scale, Hedges g = 1.51). Additionally the iCBT group had significantly lower general distress (Kessler‐10, g = 1.56), fear of cancer recurrence (Fear of Cancer Recurrence Inventory, g = 0.39), and significantly higher quality of life (Functional Assessment of Cancer Therapy—General, g = 0.74) at posttreatment compared with the TAU group. High adherence and satisfaction were found for iCBT with low clinician time. Conclusion Clinician‐supervised iCBT has significant benefits for cancer survivors with clinical depression and anxiety disorders.