Study published: E-therapists’ views on acceptability and feasibility of psychological support for parents of children treated for cancer

Support for parents of children treated for cancer

A substantial number of parents of children treated for cancer report symptoms of depression and anxiety. In response to this, U-CARE researchers have developed EJDeR, an internet-administered, guided, low-intensity cognitive behavioural therapy intervention. Delivered via the U-CARE-portal (Portal), EJDeR is designed to provide psychological support. An important part of EJDeR is that parents are in regular contact with e-therapists, who guide the parents through the EJDeR support programme and offer guidance via phone, video conferencing, and text messages. To explore the acceptability and feasibility of EJDeR and prepare for an upcoming randomised controlled trial (RCT), U-CARE researchers conducted the ENGAGE feasibility study.

The aim of the recently published study was to explore the e-therapists views on the acceptability and feasibility of EJDeR and the ENGAGE study procedure, to inform modifications prior to the RCT. Ten semi-structured interviews with e-therapists were conducted. These interviews were transcribed and analysed using mainifest content analysis. Two main themes were identified in the analysis: Acceptability and feasibility of EJDeR and Acceptability and feasibility of ENGAGE study procedures.

Acceptability and feasibility of EJDeR

E-therapists were generally satisfied with the support they received, guidance they provided to parents, and the content of the intervention. However, e-therapists also experienced challenges addressing other difficulties beyond the intervention’s primary focus. Christina Reuther, lead author of the article, explains:

One challenge raised by several e-therapists was providing support to parents with difficulties such as trauma, grief, or perfectionism. They suggested individualising and personalising EJDeR, for example, by enabling parents to speak about their cancer experience.

Acceptability and feasibility of ENGAGE study procedures

E-therapists overall perceived recruitment and training of e-therapists as acceptable, but there was a need for additional technical training and greater focus on written communication via the Portal. The Portal, which was used to deliver the EJDeR intervention, was overall considered to be user-friendly, although technical issues affected e-therapists' guidance.

One area in which e-therapists suggested improvements were parent retention. Christina Reuther explains:

Several e-therapists expressed parents not having enough time to engage with EJDeR. Lack of motivation among parents was another challenge for their retention. This could partly be explained by the fact that some parents participated in the study for altruistic reasons, rather than for their own psychological need.

Retaining e-therapists and keeping them motivated was another challenge expressed by the e-therapists.

Several e-therapists explained that they thought it was time-consuming to complete paper-based clinical records on a weekly basis, says Christina Reuther. The communication with the research team was, however, generally considered as timely and straightforward.