• Irene Teo, Yee Pin Tan, Eric A Finkelstein, Grace Meijuan Yang, Fang Ting Pan, Henry Yuen Foong Lew, Emile Kwong Wei Tan, Simon Yew Kuang Ong, and Yin Bun Cheung.
• Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore; Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore. Electronic address: irene.teo@duke-nus.edu.sg.
• J Pain Symptom Manage. 2020 Dec 1; 60 (6): 1200-1207.

ContextAdvanced colorectal cancer and its treatment can bring about challenges associated with psychological distress.ObjectivesThe primary aims of this study were to examine the feasibility and acceptability of a cognitive behavioral therapy (CBT)-based intervention to improve coping with the disease. The secondary aim is to evaluate preliminary intervention efficacy.MethodsPatients with advanced colorectal cancer in Singapore (N = 60) were randomized to either receive a four-session CBT intervention immediately or be waitlisted. Intervention feasibility (i.e., recruitment and intervention adherence) and acceptability (i.e., participant satisfaction and cultural sensitivity) were assessed. Changes in psychological distress and self-efficacy were examined.ResultsThe study successfully recruited the intended sample (mean age 61; 62% men). A proportion (12%) reported Hospital Anxiety and Depression Scale scores indicative of distress at baseline. Most (88%) completed all sessions. Participants reported high rates of satisfaction (97%), helpfulness (96%), and cultural sensitivity (95%) of the intervention. The intervention group did not show decrease in psychological distress; however, self-efficacy in cancer-related coping (information seeking: effect size [ES] = 0.64; 95% CI = 0.17, 0.85; coping with side effects: ES = 0.69; 95% CI = 0.33, 0.82; and maintaining positive attitude: ES = 0.45; 95% CI = 0.19, 0.79) increased in the intervention group compared with the waitlisted group.ConclusionThe CBT-based intervention was feasible and acceptable to patients in Singapore. There is no sufficient evidence to warrant a larger trial in this sample with low baseline distress. Future work should identify and target those who are most in need of support.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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