Objectives/purpose: Carers play a critical role supporting people with cancer, but at a cost, with over 50% of carers experiencing clinical anxiety, depression and/or fear of cancer recurrence (FCR). Few interventions addressing carer’s specific psychological needs are available. Here we detail the development of two carer-focused interventions: an online cancer-specific anxiety and depression CBT program (CarersCanADAPT iCBT); and, an online FCR program (Carer Conquer Fear). Both were developed to address carer-specific presentations of emotional concerns.
Sample and setting: Stakeholders, including cancer carers (n= 29) and psycho-oncology clinicians (n= 17) participated in parallel co-design processes.
Procedures: Stakeholders guided intervention content development and program design. Two evidence-based, cancer survivor interventions guided the therapeutic approach. For both interventions, qualitative interviews with clinicians were conducted to confirm therapeutic components, inform carer-relevant content adaptations and understand perceived barriers to program completion. Carers provided feedback related to carer-specific examples and strategies to facilitate carer engagement. Interviews were transcribed and analysed thematically.
Results: Stakeholders endorsed the use of a digital format and narrative storytelling approach as an effective strategy to convey key psychological aspects and experiences. Cancer carers indicated character scenarios were relatable, and emotional concerns reflected lived experience. Psycho-oncology clinicians endorsed core therapeutic components of each program and provided clinically relevant modifications to better tailor content through a cancer carer lens. The co-design process resulted in a 6-lesson anxiety and depression program, and a 4-lesson FCR program.
Conclusion and clinical implications: While anxiety, depression, and FCR presentations amongst carers share some common features to patient experiences, the unique needs of carers necessitate tailoring programs to reflect carer-specific psychological concerns. Involving stakeholders in the development of psychological programs is critical to ensure intervention suitability. Given the relevance of therapeutic components, adaptation of existing evidence-based interventions serves as a powerful step towards improving outcomes for this under-served group.