Poster Presentation 2025 National Cancer Survivorship Conference

Can we help carers manage fear of cancer recurrence? Developing a carer-specific online intervention (#165)

Kyra Webb 1 , Alexis Taing 2 , Rebekah Laidsaar-Powell 1 , Louise Sharpe 2 , Lisa Beatty 3 , Hannah Banks 1 , Haryana Dhillon 1 4 , Laura Kirsten 5 , Kirsty Galpin 1 , Megan Jeon 1 , Nicci Bartley 1 , Joanne Shaw 1
  1. The Psycho-oncology Co-operative Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  2. School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  3. College of Education, Psychology and Social Work, Flinders University , Adelaide, South Australia, Australia
  4. Centre for Medical Psychology and Evidence-Based Decision Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  5. Nepean Cancer Services, Nepean Blue Mountains Local Health District, Nepean, NSW, Australia

Background: Fear of cancer recurrence or progression (FCR) is a key concern for cancer carers. Nearly half of all carers (48%) report FCR levels considered clinically significant among cancer survivors, but few carer FCR interventions have been evaluated. A carer-specific intervention, underpinned by a clinically relevant carer FCR model is needed. Conquer Fear, based on the Cognitive Processing Model, is a 5-session psychologist delivered intervention with demonstrated efficacy in reducing survivor FCR.

Aims: To adapt the Conquer Fear intervention for cancer carers.

Methods: Caregiver-specific FCR experiences were first mapped to the Cognitive Processing Model. Co-design methodology was then used to review and adapt the Conquer Fear intervention to reflect the constructs underpinning carer FCR and an online format. An expert panel (psycho-oncology clinicians and researchers; n= 11) provided feedback on the clinical content and cancer carers (n= 14) reviewed the format and online approach.

Results: Various model constructs were common with FCR for cancer survivors, therefore the following components were retained: attention training, metacognitive therapy, detached mindfulness and values clarification. However, carers also expressed unique concerns including fear of losing a loved one and communication difficulties around FCR. In response, context for carer FCR was added, addressing the fears of losing a loved one and personal responsibility. We also included a session on communication. Although hypervigilance was identified amongst carers with high FCR, the behavioural contract relating to surveillance was removed. Adaptations resulted in a 4-session online program. Carers (M= 57, SD= 56.6) reported preferences for intervention character scenarios and four themes were identified: 1) FCR experience, 2) Behaviours to manage FCR, 3) Impact on communication, 4) Mental health help seeking.

Conclusions: We have developed a theoretically derived, carer-specific FCR intervention, ready for evaluation. Involving carers in co-designing the intervention may increase acceptability and will be assessed in our pilot study.