Cognitive behavioral therapies for informal caregivers of patients with cancer and cancer survivors: a systematic review and meta‐analysis

Abstract

ObjectiveInformal caregivers (ICs) of patients with cancer and cancer survivors report a number of psychological and physical complaints because of the burden associated with providing care. Given the documented effect of Cognitive Behavioral Therapy (CBT) on ICs' common psychological complaints, such as anxiety and depression, the objective was to conduct a meta‐analysis on the effect of CBTs for adult ICs.MethodsA literature search was conducted in order to identify all intervention studies on adult ICs that employed at least one therapeutic component defined as a CBT component.ResultsLiterature searches revealed 36 unique records with sufficient data. These studies were subjected to meta‐analyses using random effects models. A small, statistically significant effect of CBTs (Hedge's g = 0.08, p = 0.014) was revealed, which disappeared when randomized controlled trials were evaluated alone (g = 0.04, p = 0.200). A number of variables were explored as moderators. Only the percentage of female participants was positively associated with the effect size.ConclusionsBased on the negligible effect of CBTs across outcomes, future studies should consider moving beyond traditional CBT methods as these do not appear efficacious. It is suggested that future interventions orient towards advances in the basic affective sciences and derived therapies in order to better understand and treat the emotional struggles experienced by ICs. © 2016 The Authors. Psycho‐Oncology published by John Wiley & Sons Ltd.

A randomized control trial of stress management for caregivers of stem cell transplant patients: Effect on patient quality of life and caregiver distress

“…These changes were acceptable to caregivers. Although some studies fail to find efficacy for cognitive behavioral therapy interventions similar to PEPRR for cancer caregivers, the present study replicated efficacy in reducing CG‐distress across two different transplant programs (academic and community) as well as three interventionists but without an impact on patient's FACT‐BMT.…”

An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability

“…In fact, we noted that use of additional mental health support services was significantly lower in the PEPRR group compared to TAU [35]. Some interventions using CBT strategies have failed to show significant effects on psychosocial outcomes [12]. The efficacy of PEPRR may be due, in part, to tailoring PEPRR to the specific needs of Allo-HSCT caregivers and integrating multidimensional intervention strategies, which may have addressed broader support needs.…”

“…A broad review of interventions for cancer caregivers across the illness trajectory that included all cancer diagnoses and varying caregiverpatient relationships showed benefits of psychoeducation, problem solving/skills building, and cognitive behavioral and interpersonal interventions [11]. A more recent systematic meta-analysis of cancer caregiver interventions by O'Toole and colleagues [12] reported that cognitive behavioral therapy (CBT) had negligible effect on caregiver outcomes, supporting the idea that interventions that integrate multiple evidencebased modalities may be more effective than traditional CBT interventions.…”

The association between anxiety, traumatic stress, and obsessive-compulsive disorders and chronic inflammation: A systematic review and meta-analysis

“…was winsorized by replacing it with the lower or upper value of the range, thereby retaining the studies with an attenuated influence (cf Lipsey & Wilson, 2001;O'Toole, Zachariae, Renna, Mennin, & Applebaum, 2016)…”