CALM intervention not superior to routine supportive psycho-oncological care

While the Managing Cancer and Living Meaningfully (CALM) therapy leads to improvements in depressive symptoms over time, it does not appear to be better than supportive psycho-oncological counselling intervention (SPI), a new trial has found.

“CALM is a brief, semi-structured, individual, psychotherapeutic intervention and has been shown to be effective in alleviating depression, and enhancing hope and meaning in life,” researchers said.

In the present study, patients assigned to the CALM (n=99) or SPI (n=107) arms received a comparable number of sessions, as well as underwent a similar length of treatment. Both CALM and SPI therapists reported low adherence scores.

In both groups, depressive symptoms dropped significantly 6 months after randomization relative to baseline (p<0.001). However, at the same time point, no such between-group differences were reported in terms of depression severity, as measured by the Beck Depression Inventory (p=0.62) and Patient Health Questionnaire (p=0.998).

At baseline, CALM participants showed higher levels of attachment insecurity, which persisted until the first follow-up, 3 months after randomization. At this time point, demoralization was likewise significantly elevated in the CALM arm. However, by the final follow-up, 6 months after randomization, both secondary outcome measures were comparable between the CALM and SPI arms.

Contrary to the study hypothesis, CALM did not show superiority to SPI, though this may be due to poor treatment differentiation between the two interventions, the researchers said. “SPI therapists are familiar with psycho-oncological treatment of patients with advanced cancer for several years, thus, the application of core elements that might overlap with CALM therapy is likely.”