title: Online parent-targeted cognitive-behavioural therapy intervention to improve quality of life in families of young cancer survivors: study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Due to advances in multimodal therapies, most children survive cancer. In addition to the stresses of diagnosis and treatment, many families are now navigating the challenges of survivorship. Without sufficient support, the ongoing distress that parents experience after their child's cancer treatment can negatively impact the quality of life and psychological wellbeing of all family members.
  
  
  METHODS
  The 'Cascade' (Cope, Adapt, Survive: Life after C AncEr) study is a three-arm randomised controlled trial to evaluate the feasibility and efficacy of a new intervention to improve the quality of life of parents of young cancer survivors. Cascade will be compared to a peer-support group control and a 6-month waitlist control. Parents (n = 120) whose child (under 16 years of age) has completed cancer treatment in the past 1 to 12 months will be recruited from hospitals across Australia. Those randomised to receive Cascade will participate in four, weekly, 90-minute online group sessions led live by a psychologist. Cascade involves peer discussion on cognitive-behavioural coping skills, including behavioural activation, thought challenging, mindfulness and acceptance, communication and assertiveness skills training, problem-solving and goal-setting. Participants randomised to peer support will receive four, weekly, 90-minute, live, sessions of non-directive peer support. Participants will complete measures at baseline, directly post-intervention, one month post-intervention, and 6 months post-intervention. The primary outcome will be parents' quality of life. Secondary outcomes include parent depression, anxiety, parenting self-agency, and the quality of life of children in the family. The child cancer survivor and all siblings aged 7 to 15 years will be invited to complete self-report quality of life measures covering physical, emotional, social and school-related domains.
  
  
  CONCLUSIONS
  This article reviews the empirical rationale for group-based, online cognitive-behavioural therapy in parents of children who have recently finished cancer treatment. The potential challenges of delivering skills-based programs online are highlighted. Cascade's videoconferencing technology has the potential to address the geographic and psychological isolation of families after cancer treatment. Teaching parents coping skills as they resume their normal lives after their child's cancer may see long-term benefits for the quality of life of the family as a whole.
  
  
  BACKGROUND
  ACTRN12613000270718 (registered 6 March 2013).
authors: Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. c.wakefield@unsw.edu.au.|Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. c.wakefield@unsw.edu.au.
authors: Claire E
authors: CE
authors: Wakefield
authors: Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. ursula@unsw.edu.au.|Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. ursula@unsw.edu.au.|Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. ursula@unsw.edu.au.
authors: Ursula M
authors: UM
authors: Sansom-Daly
authors: Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. b.mcgill@unsw.edu.au.|Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. b.mcgill@unsw.edu.au.
authors: Brittany C
authors: BC
authors: McGill
authors: The Royal Children's Hospital Melbourne, Flemington Road, Parkville, VIC, 3052, Australia. Maria.McCarthy@rch.org.au.|Murdoch Childrens Research Institute, Melbourne, Flemington Road, Parkville, 3052, Australia. Maria.McCarthy@rch.org.au.
authors: Maria
authors: M
authors: McCarthy
authors: Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW Medicine, The University of New South Wales, Campbell Street, Liverpool, NSW, 2170, Australia. afaf.girgis@unsw.edu.au.
authors: Afaf
authors: A
authors: Girgis
authors: Pediatric Psychosocial Department G8-224, Academic Medical Center, Emma Kinderziekenhuis Meibergdreef 9, 1105, AZ, Amsterdam, Netherlands. M.A.Grootenhuis@amc.uva.nl.
authors: Martha
authors: M
authors: Grootenhuis
authors: Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia. belinda.barton@health.nsw.gov.au.|Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, The Children's Hospital at Westmead, Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia. belinda.barton@health.nsw.gov.au.
authors: Belinda
authors: B
authors: Barton
authors: CanTeen, Level 11, 130 Elizabeth Street, Sydney, NSW, 2000, Australia. pandora.patterson@canteen.org.au.|Cancer Nursing Research Unit (CNRU), University of Sydney, Missenden Road, Camperdown, NSW, 2050, Australia. pandora.patterson@canteen.org.au.
authors: Pandora
authors: P
authors: Patterson
authors: Youth Cancer Service South Australia/Northern Territory, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia. Michael.Osborn@health.sa.gov.au.|Michael Rice Centre for Haematology and Oncology, Women's and Children's Hospital, King William Road, North Adelaide, SA, 5006, Australia. Michael.Osborn@health.sa.gov.au.
authors: Michael
authors: M
authors: Osborn
authors: Queensland Children's Cancer Centre, Lady Cilento Children's Hospital, Stanley Street, South, Brisbane, QLD, 4101, Australia. Cherie.Lowe@health.qld.gov.au.
authors: Cherie
authors: C
authors: Lowe
authors: Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. Antoinette.Anazodo@sesiahs.health.nsw.gov.au.|Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. Antoinette.Anazodo@sesiahs.health.nsw.gov.au.
authors: Antoinette
authors: A
authors: Anazodo
authors: Acute Services: Paediatric Consultation Liaison, Princess Margaret Hospital, Roberts Road, Subiaco, Perth, WA, 6008, Australia. Gordon.Miles@health.wa.gov.au.
authors: Gordon
authors: G
authors: Miles
authors: Kids Cancer Centre (KCC), Level 1, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. r.cohn@unsw.edu.au.|Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Level 3, Sydney Children's Hospital, High Street, Randwick, NSW, 2031, Australia. r.cohn@unsw.edu.au.
authors: Richard J
authors: RJ
authors: Cohn
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001315:Australia; D002648:Child; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy; D005240:Feasibility Studies; D006801:Humans; D020407:Internet; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents / Q000523:psychology*; D010379:Peer Group; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D017216:Telemedicine / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D049269:Videoconferencing