QOL-11 - Adapting CALM Psychotherapy for Caregivers of Patients with Malignant Glioma

Caregivers of patients with malignant gliomas (PwMG) report significant emotional distress yet are often omitted from supportive psycho-oncology programs. CALM (Managing Cancer and Living Meaningfully), an evidence-based psychotherapy, has shown preliminarily to reduce depressive and existential distress among PwMG. While caregivers are invited to participate in CALM alongside the patient, the benefit of CALM for caregivers has not yet been evaluated. This NIH ORBIT model phase 1a qualitative study sought to assess caregivers’ interest in CALM and their recommendations to adapt the intervention to their emotional needs. Bereaved caregivers (N=22, M_age=47.2, 77% female, 73% White) of PwMG participated in 90-minute focus groups (n=4-7). Caregivers first received psycho-education on CALM and then participated in a semi-structured group interview. Sessions were audio-recorded, transcribed, and coded by five independent coders using thematic content analysis and NVivo software (kappa = .80-.94). Three major themes were explored: 1) CALM’s relevancy to the neuro-oncology caregiving experience; 2) the suitability of CALM for PwMG caregivers; and 3) suggested adaptations to CALM for PwMG caregivers. First, caregivers felt the four domains of CALM mirrored their experience of caregiving. Secondly, they noted both strengths and weaknesses of the intervention. Lastly, caregivers provided valuable recommendations to improve the timing (e.g., introduce CALM early, continuously), content (e.g., include sessions about bereavement and caregiver burden), and format (e.g., both independent and joint sessions) of the CALM intervention. Examples of each theme will be provided. The results suggest that CALM may be a potentially impactful intervention for the emotional needs of caregivers of PwMG. Nevertheless, adjustments to the timing, content, and format of this intervention are warranted, prior to a future feasibility/acceptability trial. This study not only provides the foundational data required to proceed with future CALM trials, but it also provides valuable considerations for those developing interventions for caregivers of PwMG largely.