A Stepped-Care Telehealth Approach in Decreasing Distress in Cancer Survivors

Inclusion Criteria

• Score >= 10 on the Generalized Anxiety Disorder-7 Questionnaire (GAD-7) and/or a score >= 8 on the Patient Health Questionnaire-9 Item (PHQ-9), indicating clinically significant anxiety or depressive symptoms, respectively
• Past history of treated (newly diagnosed or recurrent) breast, colorectal, prostate, gynecologic (only uterine and cervical) cancers (stage I, II, or III) or any stage lymphoma (Hodgkin’s or non-Hodgkin’s)
• 6-60 months post-treatment (surgery, chemotherapy, radiation therapy, and/or maintenance therapies) for cancer; time frame applies to most recent completion of treatment if participant had a cancer recurrence; it is acceptable to be on hormonal therapies
• Participant resides in California, Georgia, Illinois, Kansas, Michigan, Minnesota, Missouri, New Mexico, North Carolina, North Dakota, South Carolina, Virginia, Tennessee, or Wisconsin
• Study-trained therapist in the state where the participant resides
• Must be able to speak and understand English
• Must have access to a telephone; if a patient does not have access to a phone or has difficulty paying for minutes for a mobile phone, the research team should contact the Wake Forest investigators or site coordinators to arrange for assistance

Exclusion Criteria

• Current psychotherapy (regular appointment[s] with a psychologist, counselor, or therapist within the last 30 days prior to randomization)
• Self-reported active alcohol or substance abuse within the last 30 days
• Past history of prostate cancer or non-Hodgkin’s lymphoma with only active surveillance (i.e., no surgery, chemotherapy, or radiation therapy)
• Progressive cancer (must be considered no evidence of disease or stable)
• Self-reported psychotic symptoms in the last 30 days prior to randomization
• Active suicidal ideation with plan and intent
• Any change in psychotropic medications within the last 30 days
• Hearing loss that would preclude participating in telephone sessions (determined by brief hearing assessment administered by research staff at each National Cancer Institute Community Oncology Research Program [NCORP] component); individuals who can compensate for hearing loss through the use of a hearing device or telecommunication device for the deaf (TDD) phone, and through the use of such devices are able to communicate with the study therapist by telephone, will be included; if the therapist cannot communicate with the participant by telephone, the participant will be excluded
• Failure/inability/unwillingness to provide names and contact information for two family members or friends to serve as emergency contacts during the course of the study