Received: 17 August 2022
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Revised: 3 January 2023
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Accepted: 5 January 2023
DOI: 10.1002/pon.6097
O R I G I N A L A R T I C L E
Internet‐delivered cognitive behavioural therapy for
depression and anxiety in breast cancer survivors: Results
from a randomised controlled trial
Selin Akkol‐Solakoglu
1
| David Hevey
2
1
SilverCloud Science, SilverCloud Health Ltd,
Dublin, Ireland
2
School of Psychology, Trinity College Dublin,
Dublin, Ireland
Correspondence
Selin Akkol‐Solakoglu, SilverCloud Science,
SilverCloud Health Ltd, Dublin, Ireland.
Email: akkolsos@tcd.ie
Funding information
Trinity College Dublin
[Correction added on 08 May 2023, after first
online publication: In the Results section of
the abstract, "…Hedge's g = −0.094…" has
been corrected to "…Hedge's g = −0.94…" in
this version.]
Abstract
Objective: Depression and anxiety symptoms are common among breast cancer
survivors. Access to evidence‐based psychological therapy remains a major chal-
lenge. Despite the proven effectiveness of internet‐delivered cognitive behavioural
therapy (iCBT) in reducing depression and anxiety, the research with cancer sur-
vivors is still limited. This study evaluated the effectiveness of an iCBT intervention
on depression and anxiety, quality of life, fear of recurrence, active and avoidant
coping, and perceived social support in breast cancer survivors.
Methods: Seventy‐two participants were randomised to a 7‐module guided iCBT
intervention or treatment‐as‐usual (TAU). Depression and anxiety symptoms were
measured using the Hospital Anxiety and Depression Scale total score (HADS‐T).
The secondary measures included the European Organization for Research and
Treatment of Cancer Quality of Life Core Questionnaire (EORTC‐QLQ), Breast
Cancer Worry Scale (CWC), Brief Coping Orientation to Problems Encountered
(Brief COPE), Medical Outcomes Study Social Support Survey (MOS‐SSS). All were
completed at baseline, post‐intervention, and 2‐month follow‐up. Groups were
compared using linear mixed models.
Results: Although non‐significant, iCBT group had lower HADS‐T scores than TAU
at post‐intervention. This difference was statistically significant at 2‐month follow‐
up (Hedge's g = −0.94). No significant group‐by‐time interaction effects were found
for quality of life, fear of recurrence, active coping, avoidant coping, and perceived
social support. The intervention adherence was acceptable; 52.8% (n = 28)
completed all seven modules.
Conclusions: iCBT intervention demonstrated its preliminary effectiveness in
reducing distress in breast cancer survivors.
K E Y W O R D S
anxiety, breast cancer, cognitive behavioural therapy, depression, internet‐delivered, psycho‐
oncology
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, pro-
vided the original work is properly cited.
© 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
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Psycho‐Oncology. 2023;32:446
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456. wileyonlinelibrary.com/journal/pon
