Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

CarersCanADAPT: Results from a national randomised controlled trial of an internet-delivered psychological therapy program for cancer carers (146217)

Rebekah Laidsaar-Powell 1 , Sarah Giunta 1 , Lisa Beatty 2 , Aaron Lam 3 , Daniel SJ Costa 3 , Stephanie H Lim 4 , Phyllis Butow 1 , Ilona Juraskova 1 , Lizzy Johnston 5 , Olivia Cook 6 , Fiona Crawford-Williams 7 , Nicole M Rankin 8 , Kyra Webb 1 , Morgan Morris 3 , Joanne Shaw 1
  1. PoCoG, School of Psychology, The University of Sydney, Sydney, NSW, Australia
  2. College of Education, Psychology & Social Work, , Flinders University, Adelaide, SA, Australia
  3. School of Psychology, The University of Sydney, Sydney, NSW, Australia
  4. Macarthur Cancer Therapy Centre, Campbelltown Hospital, South Western Sydney Local Health District, Campbelltown, NSW
  5. Cancer Council Queensland, Brisbane, Queensland
  6. School of Nursing and Midwifery, Monash University, Melbourne, VIC
  7. LiveWell Cancer Centre, College of Health and Enablement, Flinders University, Adelaide, SA
  8. Evaluation and Implementation Science Unit, Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia

Aims: Cancer carers frequently experience anxiety and depression yet face substantial barriers accessing timely psychological support. To address this gap, we developed a self-led internet-delivered cognitive behavioural therapy (Carers-iCBT) program tailored to the unique needs of cancer carers, embedded within the CarersCanADAPT distress screening stepped care program. We evaluated the effectiveness of Carers-iCBT in reducing symptoms of depression and anxiety through a randomised controlled trial.

Methods: 185 Australian cancer carers experiencing symptoms of anxiety and depression were randomly allocated to the intervention (n=92) or waitlist control (n=93), exceeding the planned sample size of 166 participants. Intervention participants received access to six Carers-iCBT lessons over six weeks; control participants received carer support resources. Primary outcomes were anxiety (GAD-7) and depression (PHQ-9), assessed at baseline, post-intervention (6 weeks), and follow-up (14 weeks). Carer burden was examined as a secondary outcome. Linear mixed-effects models were used to assess intervention effects over time.

Results: The sample was majority female (85%) with a mean age of 55 years (range: 31-79 years). Most were caring for a spouse (69%), with metastatic solid tumours (35%), for 1-5 years (44%). Significant condition-by-time interaction effects were observed for depression and anxiety. Compared to control, intervention participants reported significantly lower depression symptoms at 6 (p =.001) and 14 weeks (p<.001). Anxiety symptoms were significantly lower at 6 (p=.001) and 14 weeks (p<.001). Significant condition-by-time interaction effects were observed for carer burden (p=.002). Although no between-group differences were detected at 6 weeks (p=.518), intervention participants showed reduced burden at 14 weeks (p=.047).

Conclusions: The Carers-iCBT trial demonstrates significant, sustained reductions in anxiety and depression in cancer carers. The delayed improvement in carer burden suggests that enhanced psychological wellbeing may translate into broader benefits over time. Findings confirm Carers-iCBT is an effective and scalable way of improving psychological outcomes for cancer carers.