Psycho-oncology clinicians' perceptions of blended psychological therapy for the treatment of anxiety and depression in patients with cancer: a qualitative interview study

Abstract

Abstract Background: Despite effective cancer-specific interventions for depression and anxiety, treatment uptake is low. Blended psychological therapy (BT) may improve access to treatment and enhance uptake and adherence as it combines patient-driven, online therapy with therapist-facilitated sessions. Research supports the acceptability and feasibility of BT in a noncancer context, but evidence in psycho-oncology is limited. The aim of this study was to explore psycho-oncology stakeholders' (service managers, psychologists) views on the feasibility and acceptability of BT and potential implementation of BT models into psycho-oncology care in Australia. Method: Qualitative, semistructured telephone interviews were conducted with psychologists working clinically with patients with cancer and psycho-oncology service managers. Interviews were analyzed using a framework analysis approach and mapped against the Consolidated Framework for Implementation Research domains. Results: Twenty-two clinicians (17 psychologists, 5 managers) were interviewed. An overarching theme of trust was identified, underpinned by 3 themes: (i) influence of system factors on readiness to change; (ii) treatment engagement; (iii) autonomy and empowerment. Participants shared concerns about service over-reliance on the BT digital component but also recognized its potential in expanding service reach. The use of digital technology was perceived as a barrier to patient engagement but also trusted for providing flexible access. In addition, participants voiced concerns regarding duty-of-care and lack of autonomy to deliver therapy but noted that BT could optimize clinician time and resources. Conclusion: Overall, BT was feasible and acceptable. Future research will incorporate stakeholders' preferences for and evaluation of a cancer-specific anxiety and depression BT intervention.

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