Background: The diagnosis and treatment of cancer is a major life stress such that approximately 35% of patients experience persistent clinically significant distress and carers often experience even higher distress than patients. This study reports the results of a two arm randomised controlled trial with patients and carers who have elevated psychological distress comparing minimal contact self management vs. an individualised tele-based cognitive behavioural intervention

Method: Patients (51%) and carers were recruited after being identified as high distress through caller screening at two community-based cancer helplines and randomised either to: a) a single 30-minute telephone support and education session with a nurse counsellor with self management materials or b) a tele-based psychologist delivered five session individualised cognitive behavioural intervention. Session components included stress reduction, problem-solving, cognitive challenging and enhancing relationship support and were delivered weekly. Participants were assessed at baseline and 3, 6 and 12 months after recruitment. Outcome measures include: anxiety and depression, cancer specific distress, unmet psychological supportive care needs, positive adjustment, overall Quality of life..

Results and Conclusions: Over an 8 month period, 923 patients and carers (74%) were recruited. Study retention over twelve months was 58%. There was no significant baseline difference in anxiety and depression (BSI Total scores) or or on any of the domains of unmet needs between participants in the nurse counsellor and psychologist conditions interventions. Accordingly, the interventions groups appeared to be equally distressed at baseline on key outcome measures. Preliminary outcome data on primary and secondary measures will also be discussed with regard to the implications for future research and service delivery.