Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Delivering Stepped-Care Psycho-Oncology Support Across the Cancer Pathway: Early Implementation of a Digital Model Grounded in Psycho-Oncology Practice. (126180)

Michelle R Davey 1
  1. The Cancer Rollercoaster, Hamilton Central, QLD, Australia

Up to 70% of people affected by cancer experience clinically significant psychological distress, with Fear of Cancer Recurrence (FCR) among the most persistent and under-addressed concerns (Simard et al., 2013; Butow et al., 2012). Despite national and international guidelines promoting integrated survivorship care, access to structured psycho-oncology support remains limited—particularly across key psychological transition points such as diagnosis, active treatment, completion, and recurrence (COSA, 2016; IPOS, 2018).

The Cancer Rollercoaster is an Australian digital model grounded in psycho-oncology practice that delivers stepped-care support from diagnosis through survivorship and beyond. Developed and led by a senior clinical psychologist, the model includes:

  • Tiered psychoeducational programs offering structured guidance, emotion regulation strategies, and moderated peer connection within education and support boundaries consistent with Australian clinical standards.

  • A stratified intervention for FCR, matched to symptom severity: mini-course (mild), 8-week self-paced program (moderate), or manualised, psychologist-led group therapy (severe), with fidelity protocols and clinical oversight in place (Smith et al., 2024; Thompson et al., 2024).

The model draws from evidence-based frameworks including CBT, ACT, CFT, and MCT, which inform both content and clinical interventions. Participants are triaged using a validated tool, with clinician oversight built into escalation pathways. A referral pathway to 1:1 therapy is available for individuals requiring higher-intensity support.

Currently in early-stage implementation, the model is onboarding self-referred cancer survivors and preparing for clinical integration. Preliminary engagement is underway, and the system is structured for integration into both public and private care pathways (Yang et al., 2024).

This abstract outlines the early implementation of a clinician-integrated, psycho-oncology model designed to bridge critical care gaps. It offers accessible, structured support to complement traditional services and extend care across the full cancer pathway.

  1. Butow, P., Phillips, F., Schweder, J., White, K., Underhill, C., & Goldstein, D. (2012). Psychosocial well-being and supportive care needs of cancer survivors living in urban and rural/regional areas: a systematic review. Supportive Care in Cancer, 20(1), 1–22. https://doi.org/10.1007/s00520-011-1270-1
  2. Clinical Oncology Society of Australia (COSA). (2016). Model of Survivorship Care: Full Position Statement. https://www.cosa.org.au/media/332340/cosa-model-of-survivorship-care-full-version-final-20161107.pdf
  3. International Psycho-Oncology Society (IPOS). (2018). IPOS Standard of Quality Cancer Care. https://ipos-society.org/about/quality
  4. Simard, S., Thewes, B., & Humphris, G. (2013). Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. Journal of Cancer Survivorship, 7(3), 300–322. https://doi.org/10.1007/s11764-013-0272-z
  5. Smith, A. B., Girgis, A., Taylor, N., Pearce, A., Liu, J., Shepherd, H. L., ... & Shaw, J. (2024). Step-by-step: A clinical pathway for stepped care management of fear of cancer recurrence—results of a three-round online Delphi consensus process with Australian health professionals and researchers. Journal of Cancer Survivorship. https://doi.org/10.1007/s11764-024-01685-1
  6. Thompson, J. R., Gomes, L., Kouvelis, G., Smith, A. L., Lo, S. N., Kasparian, N. A., ... & Dieng, M. (2024). Short-term effectiveness of a stepped-care model to address fear of cancer recurrence in patients with early-stage melanoma. Psycho-Oncology, 33(12), e70041. https://doi.org/10.1002/pon.70041
  7. Yang, P., Zhang, L., & Tian, X. (2024). Application of stepped care model in cancer patients: a scoping review. Supportive Care in Cancer, 33, Article 34. https://doi.org/10.1007/s00520-024-09086-x