Combined Face-to-Face and Online Cognitive-Behavioral Therapy for High Distress of Colorectal Cancer Survivors: A Case Study

Sarah Döking, Saskia Spillekom van Koulil, Belinda Thewes, Annemarie M.J. Braamse, José A.E. Custers, Judith B. Prins*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


This case study evaluates the COloRectal canceR distrEss reduCTion (CORRECT) intervention, a blended cognitive-behavioral therapy (bCBT) combining face-to-face (F2F) therapy with an interactive self-management website to reduce high distress in colorectal cancer survivors (CRCS). A cognitive-behavior therapist treated a 74-year-old male CRCS with bCBT for 4 months. At baseline, postintervention, and 7- and 14-months follow-up he filled in questionnaires assessing psychological distress (primary outcome Brief Symptom Inventory–18 [BSI-18]), anxiety, fatigue, fear of cancer recurrence, cancer-specific distress, self-efficacy, and quality of life. Reliable Change Indexes were used to analyze effects over time. Therapeutic alliance and intervention evaluation were assessed postintervention. An independent clinical psychologist performed a semi-structured interview 10 months from baseline. A detailed description shows the course of bCBT. Quantitative analyses showed improved postintervention psychological distress. Most secondary outcomes improved. Anxiety and cancer-specific distress remained improved during follow-ups. Therapeutic alliance and patient satisfaction were high. This study showed how a combined F2F and online intervention was successful in reducing distress of a cancer survivor. The treatment protocol appeared feasible and will be tested in a randomized controlled trial.

Original languageEnglish
Pages (from-to)107-123
Number of pages17
JournalCognitive and Behavioral Practice
Issue number1
Publication statusPublished - Feb 2021

Cite this