A randomized trial of videoconference-delivered cognitive behavioral therapy for survivors of breast cancer with self-reported cognitive dysfunction

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Abstract

BACKGROUND:

Long-term chemotherapy-related cognitive dysfunction (CRCD) affects a large number of cancer survivors. To the authors' knowledge, to date there is no established treatment for this survivorship problem. The authors herein report results of a small randomized controlled trial of a cognitive behavioral therapy (CBT), Memory and Attention Adaptation Training (MAAT), compared with an attention control condition. Both treatments were delivered over a videoconference device.

METHODS:

A total of 47 survivors of female breast cancer who reported CRCD were randomized to MAAT or supportive therapy and were assessed at baseline, after treatment, and at 2 months of follow-up. Participants completed self-report measures of cognitive symptoms and quality of life and a brief telephone-based neuropsychological assessment.

RESULTS:

MAAT participants made gains in perceived (self-reported) cognitive impairments (P = .02), and neuropsychological processing speed (P = .03) compared with supportive therapy controls. A large MAAT effect size was observed at the 2-month follow-up with regard to anxiety concerning cognitive problems (Cohen's d for standard differences in effect sizes, 0.90) with medium effects noted in general function, fatigue, and anxiety. Survivors rated MAAT and videoconference delivery with high satisfaction.

CONCLUSIONS:

MAAT may be an efficacious psychological treatment of CRCD that can be delivered through videoconference technology. This research is important because it helps to identify a treatment option for survivors that also may improve access to survivorship services. Cancer2016;122:1782-91. © 2016 American Cancer Society.

A randomized controlled trial comparing brief cognitive behavioral therapy (Memory and Attention Adaptation Training [MAAT]) with an attention control condition (supportive therapy [ST]) was conducted among survivors of breast cancer who reported cognitive dysfunction after chemotherapy. Both MAAT and ST were delivered over a videoconference device. MAAT participants made significant improvements in self-reported cognitive impairments and neuropsychological processing speed compared with controls. MAAT may be an effective videoconference cognitive behavioral therapy for cognitive dysfunction among survivors of breast cancer.

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