Randomized clinical trial of telephone-administered cognitive-behavioral therapy to reduce post-traumatic stress disorder and distress symptoms after hematopoietic stem-cell transplantation.
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.
DuHamel
Katherine N
KN
Memorial Sloan-Kettering Cancer Center, New York, NY, USA. duhamelk@mskcc.org
Mosher
Catherine E
CE
Winkel
Gary
G
Labay
Larissa E
LE
Rini
Christine
C
Meschian
Yeraz Markarian
YM
Austin
Jane
J
Greene
Paul B
PB
Lawsin
Catalina R
CR
Rusiewicz
Anna
A
Grosskreutz
Celia L
CL
Isola
Luis
L
Moskowitz
Craig H
CH
Papadopoulos
Esperanza B
EB
Rowley
Scott
S
Scigliano
Eileen
E
Burkhalter
Jack E
JE
Hurley
Karen E
KE
Bollinger
Andreas R
AR
Redd
William H
WH
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