Integration of Low Intensity Psychological Support for Children and Young People Receiving Cancer Services: A Qualitative Study of Staff Perspectives.

Abstract

Objective: Despite children and young people (CYP) with cancer having elevated mental health needs, accessing evidence-based psychological support remains difficult. Delivering low-intensity cognitive behavioural therapy (LICBT) to CYP with cancer could increase access to support. This qualitative study aimed to understand the views of key clinician stakeholders regarding the potential facilitators and barriers to implementation of LICBT in paediatric cancer services.

Methods: Semi-structured interviews were conducted with 39 professionals working in paediatric hospital cancer services. Interviews were transcribed and analysed using framework analysis informed by the Consolidated Framework for Implementation Research.

Results: Professionals indicated a potential need and utility for LICBT, and saw it as distinct from existing provision, addressing patient needs and filling a gap in services. Integration into the service and existing pathways was considered a key facilitator to successful implementation. Anticipated potential barriers included scepticism of LICBT efficacy due to the perceived high complexity of patient presentations and concerns about the relevance and suitability of existing manualized interventions for this population. LICBT practitioner ability to independently assess patient suitability for the intervention and to deliver LICBT effectively was also questioned.

Conclusions: Cancer professionals' perceptions of LICBT indicate its potential use for the CYP cancer population to improve access to evidence-based psychological interventions. Incorporating the identified facilitators and barriers into implementation strategies, including information about the effectiveness of LICBT for young people with chronic illness will help to ensure effective integration of LICBT into routine paediatric healthcare settings.