Ferguson, R.J., McDonald, B.C., Rocque, M.A., Furstenberg, C.T., Horrigan, S., Ahles, T.A., & Saykin, A.J. (2012). Development of CBT for chemotherapy-related cognitive change: Results of a waitlist control trial. Psycho-Oncology, 21, 176–186.

To evaluate the efficacy of a brief cognitive behavioral therapy to manage chemotherapy-related cognitive dysfunction

• Participants were randomized into a memory and attention adaptation training (MAAT) group or a waitlist to receive the intervention.
• Pre- and post-intervention cognitive testing was performed.
• The intervention consisted of 30- to 50-minute biweekly individual office visits of brief cognitive behavioral therapy to enhance cancer survivor skills for self-managing and coping with cognitive failures of daily life. The sessions included how to self-awareness training and compensatory strategies.
• Follow-up contact between visits was conducted by telephone.
• The intervention lasted eight weeks, for a total of four office visits.
• Participants in the intervention arm received a workbook.
   

• The sample consisted of 40 participants whose mean age was 50.3 years (SD = 6.4).
• The sample was 100% female.
• Participants had been diagnosed with stage I and II breast cancer.
• Participants had completed a mean total of 16.38 years of education (SD = 2.4).
• All participants were postmenopausal. 
• All received chemotherapy. 
• Twenty-three participants were taking hormonal therapy during study (30% waitlist group, 27.5% MAAT group).  
   

• Single site
• Outpatient setting
• Lebanon, New Hampshire, USA
   

• Patients were in the transition phase after initial treatment.
• The clinical applications are for late effects and survivorship.
   

Randomized clinical trial

• Multiple Ability Self-Report Questionnaire (MASQ)    
• California Verbal Learning Test-2 (CVLT-II)
• Trail Making Number-Letter Trial from the Delis Kapan Executive Function System (DKEFS)
• Color-Word-Interference from the DKEFS
• Color-Word and Switching Trials from the DKEFS
• Digit Symbol-Coding form the Wechsler Adult Intelligence Scale-III (WAIS-III)
   

Participants who received the intervention experienced a significant improvement in verbal memory, as measured by the CVLT-II total score (p < 0.05). In contrast, no difference was found in either information processing speed (DKEFS scales and WAIS-III subscale) or patients’ self-report (MASQ) of their cognitive functioning.

Although the cognitive behavioral therapy intervention was formulated to assist patients in dealing with memory and attention problems, significant improvement in total score was found only in verbal memory. Because improvement was not found in information processing speed, alternative strategies may need to be developed to help patients compensate in other cognitive domains. Although patients reported high satisfaction with the intervention, self-report scores did not indicate any improvement in their cognitive functioning.

• The sample size was less than 100.
• The number of intervention sessions was limited, which limited the generalizability of results and the feasibility of the intervention.
• No attentional control condition was used.
   

Ongoing cognitive problems have been reported by many patients after completion of cancer treatment. Cognitive behavioral training has been suggested as a strategy to assist patients in dealing with the impact of these problems. However, further studies are needed to determine strategies for specific cognitive domains that are feasible in the outpatient setting.