CBT-based Online Self-help Training to Reduce Fear and Distress After Cancer (CAREST Randomized Trial): 24 Months Follow-up Using Latent Growth Models and Latent Class Analysis.

Many people experience distress and fear of recurrence after surviving cancer. Online psychological interventions have benefits, such as easy accessibility, flexibility, and low costs. But do they really help? In this study, we evaluated whether an online self-help training could reduce distress and fear of recurrence in breast cancer survivors. We compared two groups of patients; one received online self-help training and the other did not. Our first finding is that cancer survivors stay distressed and fearful for a long time (24 months in our study). A second finding is that we found five groups of patients with distinct levels of fear of recurrence and predictors for this fear. For instance, one group consisted of younger women with severe fear and more mental problems. Another group consisted of older women with mild fear but more physical problems. The most important finding of this study is that we did not find an effect of our self-help training. The persistence of distress and fear, and the different groups of cancer survivors with their specific characteristics and needs, underline the importance of developing effective psychological interventions. Given the benefits of online interventions, we recommend future studies concerning online interventions that provide professional support.