Limitations & Conclusions
This study had several limitations. First, there was no control group to compare to those in active treatment. Thus, we could not account for the effects of time and attention, or possible regression to the mean. To attribute these positive results to the effect of this CBT intervention will require a randomized, controlled trial or a waitlist control group design.
A second limitation was a potential bias in recruitment of participants. Although invitation letters were sent to all families at the CF Center, pwCF who enrolled in this study tended to have lower lung function than the CF Center generally, and two pwCF were being evaluated for the lung transplant list.
Third, this intervention was not as comprehensive or structured as a traditional CBT treatment because it was shorter (4 sessions; usually 8 to 10) and was not guided by a manual. Instead, it was individualized to the concerns participants’ raised about their own needs.
Finally, this intervention was limited by a small sample size. Although we obtained statistically significant decreases in both stress and depression, this study was underpowered. This might have accounted for the lack of statistical significance in anxiety scores, which decreased but did not meet standard, p<.05 criteria.
Results showed that this intervention was effective, feasible and satisfactory. However, it is not a substitute for a comprehensive intervention or ongoing psychological support from a mental health expert on the CF Team. A future randomized, controlled trial of this intervention is being planned to test its efficacy.