Aim: Psychological therapies, combined with medication where appropriate, are effective in improving outcomes of cancer patients with depression. However, in Australia, current psycho-oncology workforce is insufficient to meet patient need. To bridge this gap, innovative models of care delivery are urgently required. To support implementation of a community-based shared care model, training of community-based psychologists to deliver evidence-based cancer-specific treatment is required. The aim of this research was to develop and assess the acceptability, clinical relevance and face validity of a cancer-specific manualised therapy and associated training to facilitate skill development among community-based clinical psychologists.
Methods: To inform manual development a comprehensive review of the literature and Gap Analysis was conducted. An iterative approach led by an expert panel of psycho-oncology clinicians was applied to manual development. Session content of the cancer-specific manualised therapy was based on cognitive behavioural therapy (CBT) principles. Stakeholder review of the manual was conducted using a structured evaluation format with open-text responses and/or optional semi-structured interview. Both community and hospital-based clinical psychologists were recruited. Responses were analysed using a content analysis approach. Manual content was revised based on feedback.
Results: A six core and four booster session cancer-specific CBT manual was developed. Stakeholder feedback (n=11) confirmed overall acceptability and face validity of the manual and associated training. Content was reported to be clinically relevant. Experienced hospital-based psychologists highlighted additional content on cognitive re-structuring techniques for cancer patients and importance of associated oncology training. For community psychologists, level of content in session one and need for cancer-specific examples across sessions was highlighted. Feedback was mapped onto existing sessions.
Conclusions: Implementation of community-based models of care require evidence-based training of community clinical psychologists to facilitate effective treatment. Development of a cancer-specific depression therapy manual and associated training to support psychologists is the first step in expanding the psycho-oncology workforce.