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.