Tailored internet-delivered cognitive behavior therapy for breast cancer patients: a randomized controlled trial with an active control group.

Psychological distress is common among breast cancer survivors. Psychosocial interventions can be effective but rarely consider heterogeneity of symptoms. The present study investigated the effects of therapist-supported tailored internet-delivered cognitive behavioral therapy (ICBT) for cancer-related psychological symptoms in breast cancer survivors. Seventy breast cancer survivors reporting elevated levels of depressive and/or anxiety symptoms were recruited and randomized to take part in either ICBT (n = 35) or a moderated online discussion forum (n = 35). The ICBT condition was tailored according to the problems reported by the participant. Questionnaires assessing psychiatric and cancer-related psychological symptoms, quality of life, and benefit finding were used. Data were collected before and after the treatment phase at week 10, as well as after six months, and the study was completed back in 2008. The results at the posttreatment indicated significant differences across all outcomes favoring the ICBT condition. Effect sizes ranged between small (Cohen's d = -0.35) for body change stress, and large for symptoms of depression and anxiety (Cohen's d = -0.89). Symptom levels were sustained for the ICBT group at follow-up but with few between-group differences. The results indicate that tailored ICBT can help breast cancer patients who experience psychological distress following medical treatment.