Internet-based Cognitive Behavioral Therapy for DSM-IV Sexual Dysfunctions in Breast Cancer Survivors: Predictors of Treatment Response

Abstract

Objectives: We evaluated factors predictive of the effect of internet-based cognitive behavioral therapy (CBT) in breast cancer survivors with a sexual dysfunction. Methods: Fifty-five women completed questionnaires assessing sexual functioning and distress at baseline and post-CBT. Results: Higher therapy compliance and better partner baseline sexual functioning predicted better post-CBT sexual functioning. Higher therapy compliance and higher partner relationship satisfaction predicted lower sexual distress. Therapy compliance, in turn, was predicted by active partner involvement in therapy and a stronger therapeutic relationship. Conclusions: To increase the effect of internet-based CBT, we recommend partner involvement in therapy and establishing a strong therapeutic relationship.

Keywords:

• Breast cancer
• cognitive behavioral therapy
• internet-based
• sexual dysfunction
• DSM-IV

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Acknowledgments

We would like to thank Miranda Gerritsma and Marianne Kuenen for their contribution to the data collection and entry, and Hannah Lassche and Aukje Schade for their work and dedication as therapists (along with Eva Broomans and Daniela Hahn). We thank the patients and their partners for their willingness to participate in the study. We also thank the following colleagues for facilitating our recruitment of women into the study: Nina Bijker (Academic Medical Center), Paul Borgstein (Onze Lieve Vrouwe Gasthuis, location East), Gijsbert Heuff (Spaarne Gasthuis Hoofddorp), Alexander Lopes Cardozo (Northwest Clinics Alkmaar), Peter Plaisier (Albert Schweitzer Hospital), Herman Rijna (Spaarne Gasthuis Haarlem), Suzan van der Meij (Flevo Hospital), Eric van Dulken (Medical Center Slotervaart), and Bart Vrouenraets (Onze Lieve Vrouwe Gasthuis, location West). We thank Virenze Institute of Mental Health Care for the collaboration in the development of the internet-based CBT, the employment of the sexologists and providing the Internet platform to the participants.

Additional information

Funding

This study was supported financially by the Dutch Cancer Society (grant number NKI 2012-5388), the Pink Ribbon Foundation (grant number 2012.WO21.C138), and The Netherlands Cancer Institute.