Department of Psychology and Behavioural Sciences

A randomized controlled trial of emotion regulation therapy for psychologically distressed caregivers of cancer patients

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  • Mia Skytte O'Toole
  • Douglas S. Mennin, Teachers College Columbia University, New York, United States
  • Allison Applebaum, Memorial Sloan-Kettering Cancer Center, United States
  • Britta Weber
  • Hanne Rose, Institut for Klinisk Medicin - Onkologisk Afdeling, Denmark
  • David M. Fresco, Kent State University, United States
  • Robert Zachariae
Previous cognitive behavioral therapies (CBTs) for informal caregivers (ICs) have produced negligible effects. The purpose of the current study was to evaluate, in a randomized controlled trial (RCT), the efficacy of Emotion Regulation Therapy (ERT-C) on psychological and inflammatory outcomes in psychologically distressed ICs and the cancer patients cared for.

81 ICs with elevated psychological distress were randomized to ERT-C or a waitlist condition, and assessed pre-, mid-, and post-treatment. In 52 cases, the patient cared for by the IC was included. Patients did not receive ERT-C. Both the ERT-C and waitlist groups were followed 3- and 6 months post-treatment. Data were analyzed with multilevel models. P values were two-sided.

Compared with ICs in the waitlist condition, ICs in the ERT-C condition experienced medium to large statistically significant reductions in psychological distress (p<.001, g=0.86, 95% CI [0.40, 1.32]), worry (p<.001, g=0.96, [0.50, 1.42]), and caregiver burden (p=.007, g=0.53, [0.10, 1.99]) post-treatment. No effects were found for rumination (p=.220, g=0.24, [-0.20, 0.68]). Results concerning caregiver burden were maintained through 6 months follow-up. Although the effects on psychological distress and worry diminished, their end-point effects remained medium to large. No effects on systemic inflammation were detected (CRP: p=.570, g = .17 [-0.27, 0.61]; IL-6: p=.205, g = .35 [-0.09, 0.79]; TNFα: p=.686, g = .11 [-0.33, 0.55];). Patients whose ICs attended ERT-C experienced a large increase in quality of life post-treatment (p=.017, g=0.88, [0.18, 1.58]).

This is the first RCT evaluating the efficacy of ERT-C for ICs. Given the previous disappointing effects of other CBTs for this population, the present findings are very encouraging. Identifying ICs with elevated psychological distress and providing them with relevant psychotherapy appears an important element of comprehensive cancer care.
Original languageEnglish
Article numberpkz074
JournalJNCI Cancer Spectrum
Publication statusPublished - 2020

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