title: Randomized clinical trial of telephone-administered cognitive-behavioral therapy to reduce post-traumatic stress disorder and distress symptoms after hematopoietic stem-cell transplantation.
abstract: OBJECTIVE
  A significant number of survivors of hematopoietic stem-cell transplantation (HSCT) report enduring adverse effects of treatment, including illness-related post-traumatic stress disorder (PTSD) symptoms and general distress. We report results of a randomized clinical trial that tested the effects of a 10-session, telephone-administered cognitive-behavioral therapy (CBT) intervention on PTSD, depression, and distress symptoms.
  
  
  METHODS
  Survivors who had undergone HSCT 1 to 3 years earlier (N = 408) were assessed for study eligibility. Those who met study eligibility criteria (n = 89) completed a baseline assessment that included a clinical interview and self-report measures of PTSD symptoms (the primary outcome) and depression and general distress (the secondary outcomes). Next, they were randomly assigned to CBT or an assessment-only condition. Survivors in the CBT group completed 10 individual telephone-based CBT sessions (T-CBT) that included strategies to reduce PTSD symptoms, depression, and general distress. Follow-up assessments occurred at 6, 9, and 12 months after the baseline assessment.
  
  
  RESULTS
  Linear mixed-model analyses revealed that, compared with HSCT survivors in the assessment-only condition, survivors who completed T-CBT reported fewer illness-related PTSD symptoms, including less avoidance (P < .001) and fewer intrusive thoughts (P < .05) as well as less general distress and fewer depressive symptoms (P < .05) even after controlling for potential demographic and medical covariates. These results were consistent across the three follow-up assessments.
  
  
  CONCLUSIONS
  A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA. duhamelk@mskcc.org
authors.forename: Katherine N
authors.initials: KN
authors.lastname: DuHamel
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Mosher
authors.forename: Gary
authors.initials: G
authors.lastname: Winkel
authors.forename: Larissa E
authors.initials: LE
authors.lastname: Labay
authors.forename: Christine
authors.initials: C
authors.lastname: Rini
authors.forename: Yeraz Markarian
authors.initials: YM
authors.lastname: Meschian
authors.forename: Jane
authors.initials: J
authors.lastname: Austin
authors.forename: Paul B
authors.initials: PB
authors.lastname: Greene
authors.forename: Catalina R
authors.initials: CR
authors.lastname: Lawsin
authors.forename: Anna
authors.initials: A
authors.lastname: Rusiewicz
authors.forename: Celia L
authors.initials: CL
authors.lastname: Grosskreutz
authors.forename: Luis
authors.initials: L
authors.lastname: Isola
authors.forename: Craig H
authors.initials: CH
authors.lastname: Moskowitz
authors.forename: Esperanza B
authors.initials: EB
authors.lastname: Papadopoulos
authors.forename: Scott
authors.initials: S
authors.lastname: Rowley
authors.forename: Eileen
authors.initials: E
authors.lastname: Scigliano
authors.forename: Jack E
authors.initials: JE
authors.lastname: Burkhalter
authors.forename: Karen E
authors.initials: KE
authors.lastname: Hurley
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Bollinger
authors.forename: William H
authors.initials: WH
authors.lastname: Redd
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000628:therapy*; D013689:Telephone; D055815:Young Adult