Abstract BACKGROUND Many adults with brain tumors experience double vulnerability—significant emotional distress alongside cognitive decline. These cognitive changes often prohibit their inclusion in psychotherapeutic intervention research due to restrictive eligibility criteria; however, small adaptations may support cognitive accessibility and enable engagement in interventions that promote wellbeing. This analysis aimed to identify and evaluate strategies to accommodate the neurocognitive needs of patients with brain tumors to enhance their engagement in psychotherapeutic interventions. MATERIAL AND METHODS We conducted a series of feasibility studies of Managing Cancer and Living Meaningfully (CALM), a 6-session psychotherapeutic intervention, in adults with primary and secondary brain tumors. First, in a single-arm pilot trial, 18 participants rated which evidence-informed accommodations would support their cognitive limitations and enhance engagement in future trials during exit interviews. Recommendations proposed by 60% were integrated into the subsequent randomized pilot trial, in which 28 participants reported by dichotomous scale (yes/no) whether these cognitive accommodations were beneficial during the CALM intervention. RESULTS Participants in the single-arm pilot trial (N=18) recommended appointment reminders (100%), CALM topic refreshers (94%), prior session summaries (88%), CALM visual handouts (82%), time in-session for content consolidation (71%), and notepads (65%). These accommodations were incorporated into the subsequent randomized pilot trial, of which participants (N=28) reported the following as beneficial: appointment reminders (96%), prior session summaries (96%), CALM topic refreshers (88%), time in-session for content consolidation (89%), CALM visual handouts (69%), and notepads (48%). CONCLUSION Participants with primary and secondary brain tumors most recommended evidence-informed cognitive accommodations included: 1) appointment reminders to support session attendance, 2) CALM topic refreshers and prior session summaries to support memory, and 3) additional time to assist with slower processing and support comprehension during conversation. Notepads were highly recommended in the single-arm pilot, but were considered less beneficial in the randomized pilot trial. Targeted adaptations, such as providing an interactive participant workbook rather than a blank notepad, may bolster the benefit for participants. Implementing supportive cognitive strategies is vital to promoting neuro-oncology inclusion in psychotherapeutic interventions and meeting the needs of this underserved population.
Loughan et al. (Wed,) studied this question.
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