Why the research is needed
Patients in cancer care are up to three times more likely to suffer from common mental health problems such as depression, resulting in poorer adherence to cancer treatments, higher medical costs, and worse overall health outcomes. Psychological therapies have been found to be effective in treating depression in oncology patients. However, patients referred for psychological therapy often must wait several weeks or months to access therapy during which time their mental health can worsen.
What is already known about the subject
Evidence suggests that timely and accessible brief interventions offered whilst patients are awaiting psychological therapy may help improve depressive symptoms, mental health and overall quality of life and reduce dropout rates.
This study aims to evaluate the effectiveness of a brief Therapy Preparation Intervention for adult patients in cancer care awaiting psychological therapy for moderate-to-severe depression. The intervention includes a session at the start of the wait, covering preparation for psychological therapy and goal setting, and automated text reminders of the session's content until their psychological therapy begins.
Who we will be working with
This trial is supported by the East Midlands Cancer Alliance and will be conducted at the East Midlands Cancer Alliance Centre for Psychosocial Health (an established service providing psychological therapy for patients in cancer care and training for cancer care staff). We will invite NHS cancer care services and GP practices across the East Midlands to take part by referring their patients to the study.
How patients and the public are involved
Patient and public representatives highlighted the need for this intervention. Specifically, they have contributed to the design of the study and refining the recruitment processes and patient-facing documents, including the participant information sheet and assessment questionnaires. Through quarterly meetings, their involvement will continue throughout the study with tasks which include but are not limited to supporting and advising recruitment processes, monitoring participant-facing materials, and interpreting study findings and dissemination.
What we will do
We will run a trial to assess whether a therapy preparation intervention combined with standard care is more effective than standard care alone. Participants will be randomly allocated to either the intervention group, which will receive the therapy preparation intervention in addition to standard care, or the standard care group. Follow-up assessments will take place at 4, 8, 12 and 24-weeks, evaluating psychological wellbeing and functioning, and psychological therapy dropout. Additionally, 20-30 participants from the intervention group will be interviewed about their experiences with the Therapy Preparation Intervention.
What will the benefits of the study be?
The problems associated with waiting times affect almost all healthcare services. Therefore, this study explores ways of helping patients whilst they wait for psychological therapy as well as other treatments. The intervention aims to enhance patients' readiness for treatment through enhancing overall psychological support and therapy effectiveness and decreasing dropout rates. The qualitative interviews will identify key intervention strengths and areas for future improvement. If the intervention is found to be effective, it could be offered as part of routine NHS care.
When the findings will be available
The results of this study are anticipated to be available by March 31, 2026.
How are we planning for implementation
If found to be effective, this intervention will be adopted by the East Midlands Cancer Alliance Centre for Psychosocial Health who will support implementation in other cancer care services across the East Midlands. The East Midlands Cancer Alliance will support dissemination across other cancer alliances nationally to support wider implementation. The study's results will also be shared at international conferences and in peer-reviewed journal papers.
Contact
Study researchers Clem Boutry and Paulina Hagyari-Donaldson, University of Nottingham, PROSPER@nottingham.ac.uk.