a stressed person

Stress Management in Cancer

An interactive cognitive behavioral coping and stress management intervention

Project period



The Norwegian Cancer Society   (Kreftforeningen #4602492)


A cancer diagnosis and subsequent treatment can be disruptive and traumatic, often accompanied by a multitude of stressors for the patients. Uncertainty of outcome and invasive medical procedures with aversive side effects are not uncommon, and while people differ widely in how they experience and cope with such challenges, cancer related distress including anxiety, depression, worry and rumination is prevalent. Psychosocial interventions in cancer can facilitate psychological adaptation to cancer, including reducing distress, anxiety, negative affect and depression, as well as improving QoL.

In this study we will combine well-established stress management interventions for cancer patients developed at the Mayo Clinic with cutting edge computerized technology at the Center for Shared Decision Making and Collaborative Care Research (CSDM) at Oslo University Hospital (OUS), creating an innovative computer assisted interactive cognitive behavioral coping and stress management intervention for cancer patients in Norway.

In phase I (2015/2016), the intervention is developed, tailored and piloted for Norwegian conditions in collaboration with a patient advisory board and specialists in psychosocial oncology, stress management, and eHealth.

In phase II (2017/2019), the effect of the Norwegian Computerized Interactive Stress Management (N-CISM) intervention will be tested with repeated measures in a randomized controlled trial (RCT), examining impact on stress, distress, QoL, self-regulation, coping, and health behaviors. Participants will be cancer patients (N = 260) in Norway diagnosed with different cancer types and randomized to either the intervention or to standard care.

After an introductory face to face group session, 10 modules centering around stress management and QoL will be facilitated online. If effective, the N-CISM has the potential to generally enhance well-being, self-management and sense of self-control for patients living with cancer in Norway. The intervention can provide extensive outreach, improved flexibility and high accessibility for a diverse group of cancer patients in more cost-effective ways, potentially also reducing burden on the health care system. 


  • Matthew M. Clark, PhD

    Mayo Clinic, Rochester, MN, USA

  • Shawna L. Ehlers, PhD

    Mayo Clinic, Rochester, MN, USA

  • Michael Andrykowski, PhD

    University of Kentucky, KY, USA