Effectiveness of Conventional Cognitive-Behavioral Therapy and Its Computerized Version on Reduction in Pain Intensity, Depression, Anger, and Anxiety in Children with Cancer: A Randomized, Controlled Trial

Abstract

Background: Experiencing painful procedures during life is inevitable. Poor pain management is associated with negative effects on the quality of life, remaining for a long time after the experience. Long-term negative effects of pain possess a significant cost burden on society. Nowadays, computers are globally available, and computerized psychological interventions can reduce negative emotions. Objectives: The present study aimed at examining the effectiveness of conventional cognitive-behavioral therapy (CBT) and its computerized version on reduction in pain intensity, depression, anger, and anxiety in children with cancer. Methods: The present randomized, controlled, clinical trial was performed on three groups of conventional CBT, computerized CBT (cCBT), and control. Children with cancer, referring to Shafa Hospital of Ahvaz, Iran, constituted the study samples. A total of 15 children aged 9 - 12 years were assigned to each group by using the lottery method. All three groups received routine medical treatments during the study, but the two intervention groups also received psychological interventions as a complementary treatment. The control group received routine medical treatment and underwent cCBT intervention after the study. The data-i e, pre- and post-tests, were collected by a masters’ student in clinical psychology that was blind to the study objectives. Data were analyzed by MANCOVA, ANOVA, and t-tests of differential scores. Results: The findings of the study indicated that both interventions could reduce negative emotions associated with cancer (i. e, pain, anger, anxiety, and depression) in children compared with the control group (P < 0.0001). In addition, there were no significant differences between the two intervention groups (P < 0.01). It means both interventions were useful to reduce pain and enhance adjustment. Conclusions: The cCBT can be utilized in case of no access to psychologists and psychological services.

Effectiveness of technology‐based psychosocial interventions for child, adolescents and young adults undergoing cancer treatment: A meta‐analysis of randomised controlled trials

“…As shown in Table 1, 12 RCT studies (Akard et al, 2015; Alemi et al, 2016; Barry et al, 2010; Fazelniya et al, 2017; Gerçeker et al, 2021; Hamedi et al, 2020; Jones et al, 2010; Nguyen et al, 2010; Piasai et al, 2018; Robb et al, 2014; Tennant et al, 2020; Zhang et al, 2019) evaluating 640 patients were included in our study. The year of publication of the studies ranged from 2010 to 2021.…”

“…Ten studies included children with any form of cancer (heterogeneous types of cancer); one study enrolled children with leukaemia (Nguyen et al, 2010); the remaining study (Jones et al, 2010) recruited children diagnosed with any kind of solid tumours. Intervention groups that received technological‐based psychosocial interventions were compared with control groups that received standard care (Akard et al, 2015; Alemi et al, 2016; Barry et al, 2010; Fazelniya et al, 2017; Gerçeker et al, 2021; Hamedi et al, 2020; Nguyen et al, 2010; Piasai et al, 2018; Zhang et al, 2019) or minimal interventions (Jones et al, 2010; Robb et al, 2014; Tennant et al, 2020). Of all included studies, the average duration of intervention was 19.91 ± 26.02 days (range: 1–90).…”

“…Four trials with 171 children undergoing cancer treatment evaluated the effects of technology‐based interventions on anger (Alemi et al, 2016; Hamedi et al, 2020; Piasai et al, 2018; Tennant et al, 2020). Our meta‐analysis results (Figure 3) showed that a significant effect was observed for the anger change in children with cancer in favour of technology‐based psychosocial intervention ( g = −1.327, 95% CI: [−2.432, −0.223], p < 0.05, I 2 = 88.3%).…”

“…Six trials (Alemi et al, 2016; Gerçeker et al, 2021; Hamedi et al, 2020; Nguyen et al, 2010; Tennant et al, 2020; Zhang et al, 2019) covering 319 children evaluated the effectiveness of technology‐based psychosocial interventions as anxiety treatment of patients with cancer. Our meta‐analysis identified large effect on anxiety of children undergoing cancer treatment in favour of technology‐based psychosocial intervention ( g = −0.894, 95% CI: [−1.349, −0.187], p < 0.05).…”

Effects of cognitive cehavioral play therapy techniques on low self-esteem among students

“…Low self-esteem also related with depression and anxiety (Ghasemian Siahkalroudi & Zarbakhsh Bahri, 2015;Martinsen, et al, 2021). Low self-esteem also has anegative effect on students who are facing it which they tend to over-generalize the negative results of a troubling situation and believe that is difficult to fix their negative tendencies (Galanakis, Palaiologou, Patsi, Velegraki, & Darviri, 2016;Hamedi, Hamid, Beshlideh, Marashi, & Sheikh Shabani, 2020).…”