Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 18, 2020
Date Accepted: Jun 17, 2021
Date Submitted to PubMed: Jun 25, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Guided, internet-administered, low-intensity Cognitive Behavioral Therapy, for the treatment of Depression and/or Generalized Anxiety Disorder in parents of children treated for cancer: Development and overview of the EJDeR intervention
ABSTRACT
Background:
Parents of children treated for cancer may report psychological distress following the end of treatment. However, psychological support needs are commonly unmet and there is lack of evidence-based interventions tailored to the population. An internet-administered low-intensity Cognitive Behavioral Therapy (CBT) based self-help intervention (EJDeR; intErnetbaserad sJälvhjälp för förälDrar till barn som avslutat en behandling mot canceR) may provide a solution.
Objective:
To describe the development of the EJDeR intervention adopting the Template for Intervention Description and Replication (TIDieR) checklist to detail specific intervention factors.
Methods:
EJDeR was developed through a multistage approach, including the use of existing evidence, conceptualization of distress, participatory action research, cross- sectional survey, and professional and public involvement. It utilizes low-intensity CBT behavioral activation and worry management treatment protocols for Depression and/or Generalized Anxiety Disorder tailored towards the population. EJDeR is delivered via the U-CARE-portal, an online platform including written, film, audio content and videoconferencing, in-portal e-mail guidance, logging of participant and therapist activity, and automatic reminders. Parents are guided to use EJDeR by e-therapists, comprising psychology program students, in at least their fourth year of study after having completed a term of advanced studies in CBT.
Results:
An overview of the development process and a description of EJDeR informed by the TIDieR checklist are presented. Adaptations to EJDeR made in response to public involvement are highlighted. EJDeR is currently being tested in a feasibility study of an internet-administered intervention for parents of children previously treated for cancer (the ENGAGE study).
Conclusions:
EJDeR represents a novel approach to support parents of children treated for cancer. Adopting a low-intensity CBT approach, guided by e-therapists, and internet-administered delivery represents a unique approach to improve access to mental health support for parents of children treated for cancer. Adopting TIDieR to report EJDeR offers potential to enhance fidelity to the intervention protocol and facilitate later implementation. Clinical Trial: ENGAGE study: ISRCTN 57233429
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