The Feasibility and Acceptability of a Cognitive Behavioral Therapy-Based Intervention for Patients With Advanced Colorectal Cancer.

Journal Article (Journal Article)


Advanced colorectal cancer and its treatment can bring about challenges associated with psychological distress.


The primary aims of this study were to examine the feasibility and acceptability of a cognitive behavioral therapy (CBT)-based intervention to improve coping with the disease. The secondary aim is to evaluate preliminary intervention efficacy.


Patients with advanced colorectal cancer in Singapore (N = 60) were randomized to either receive a four-session CBT intervention immediately or be waitlisted. Intervention feasibility (i.e., recruitment and intervention adherence) and acceptability (i.e., participant satisfaction and cultural sensitivity) were assessed. Changes in psychological distress and self-efficacy were examined.


The study successfully recruited the intended sample (mean age 61; 62% men). A proportion (12%) reported Hospital Anxiety and Depression Scale scores indicative of distress at baseline. Most (88%) completed all sessions. Participants reported high rates of satisfaction (97%), helpfulness (96%), and cultural sensitivity (95%) of the intervention. The intervention group did not show decrease in psychological distress; however, self-efficacy in cancer-related coping (information seeking: effect size [ES] = 0.64; 95% CI = 0.17, 0.85; coping with side effects: ES = 0.69; 95% CI = 0.33, 0.82; and maintaining positive attitude: ES = 0.45; 95% CI = 0.19, 0.79) increased in the intervention group compared with the waitlisted group.


The CBT-based intervention was feasible and acceptable to patients in Singapore. There is no sufficient evidence to warrant a larger trial in this sample with low baseline distress. Future work should identify and target those who are most in need of support.

Full Text

Duke Authors

Cited Authors

  • Teo, I; Tan, YP; Finkelstein, EA; Yang, GM; Pan, FT; Lew, HYF; Tan, EKW; Ong, SYK; Cheung, YB

Published Date

  • December 2020

Published In

Volume / Issue

  • 60 / 6

Start / End Page

  • 1200 - 1207

PubMed ID

  • 32574657

Electronic International Standard Serial Number (EISSN)

  • 1873-6513

International Standard Serial Number (ISSN)

  • 0885-3924

Digital Object Identifier (DOI)

  • 10.1016/j.jpainsymman.2020.06.016


  • eng