Is Telehealth an effective means of implementing psychosocial support to adolescents and young adults (AYA’s) with cancer?

INTERVENTION: Receiving psychosocial care and evaluation by telehealth by a psychologist/social worker. The assessment will be administered via telehealth using a WebEx interface across the internet. Questionnaires will also assist in the evaluation and care processes. Communication for appointments may be via letter, email, text messaging, or phone. Semi‐structured clinical interview based on the validated Home & Environment Education, Employment Eating Exercise Activities and Drugs Sexual activity Sexuality and Suicide/Mental Risk (HEADSS) assessment. The assessment involves discussing a range of important aspects relating to the young persons psychosocial and mental health issues, family, peers, relationship, school and other concerns. This may involve incidental supportive counselling and may involve incidental support through cognitive behavioural coping strategies. however the primary intervention is the structural interview process. The assessment is intended to take approximately 15‐20 minutes for completion of questionnaires and about 5 minutes after the interview assessment. The assessment with the psychologist will take approximately 1 hour. The evaluation and care will be assessing satisfaction of care, perceptions of care providers, anxiety and depression aspects. The psychosocial assessments will be administered at baseline, 6 months, 12 months and 24 month timepoints. CONDITION: Cancer Psychosocial wellbeing in AYA population PRIMARY OUTCOME: 1. Acceptability of the assessment ; Measured using: ; *Youth Satisfaction Questionnaire (YSQ)17,18: 5 items assessing satisfaction with care and overall experience, followed by several ratings of specific aspects of psychosocial assessment process. ; *Acceptability questions about online assessment/intervention relative to a hypothetical in‐person version (or vice versa) by participant and by staff ; *The Working Alliance Inventory (Horvath & Greenberg 1983) : 12 items assessing the young person’s perceptions of their relationship (rapport and understanding) with the AYA clinical psychologist/social worker who conducted their assessment. This questionnaire has been modified to use Australian terminology. ; *Treatment Credibility and expectations questionnaire (modified for the purposes of this study). ; ; 2. Feasibility ; *Protocol adherence to ‘gold‐standard’ processes (e.g., frequency of multi‐disciplinary teams (MDTs) where all the necessary people are there, proportion of times that a GP chooses to be ‘linked in’ to the process, etc) ; *Technical difficulties and logistical aspects of delivering/receiving intervention including Kilometers from YCS to home in kilometers (using Google maps) and total time taken to travel to appointment, including travel and parking time as well as any out of pocket expenses (eg parking, petrol). One direction only. ; *% appointments conducted within a reasonable timeframe, timeliness of assessment administration ; 3. Distress and Quality of Life during study period ; *AYA Oncology Screening Tool ; *Kessler10 (assesses anxiety and depression symptoms in the past 4 weeks). There are 10 items widely used with Australian AYAs and recommended as the Australian Federal Government mental health measure. ; *AYA cancer‐specific quality of life: Peds‐QL‐AYA (Ewings etc 2009) ; ; SECONDARY OUTCOME: 4. Cost‐effectiveness / cost‐utility: Eight items will be devised in consultation with the Cancer Research Economics Support Team (CREST), an initiative of Cancer Australia. ; 1. How the participant heard about the service ; 2. Demographics ; 3. Understanding of telemedicine and how they feel about having support using this method, as well as preferred method of support at baseline in an ‘ideal‐world’ situation ; *Also, comparison of the cost of delivering psychosocial service in‐person or by teleconference will be made. Savings for patients and their families in terms of distance, time and expense per visit will be collected for all the patients. ; 4. Whether the patient has ever seen a AYA clinical psychologist/social worker or counselor before ; 5. Tumour type and stage (validated Treatment Intensity Scale) ; 6. Intended treatment intent (curative or palliative) ; 7. % patients who decline the allocated arm and choose to participate on the other treatment arm, % attrition ; 8. Reliability checks regarding therapist adherence ; ; INCLUSION CRITERIA: 1. AYA cancer patients aged between 15 years and 25 years. 2. Patients who have been newly diagnosed or who have relapsed with a malignant haematological or oncological diagnosis 3. Patients who will undergo curative or palliative therapy which may include chemotherapy, surgery and radiotherapy in different combinations. 4. AYA patient being treated at any paediatric or adult cancer centre in NSW and ACT 5. Patient who are mentally/physically able to participate in either in‐person psychosocial assessment or teleconference consultations. 6. Patients who speak limited English can be enrolled as long as the sessions are undertaken with an interpreter present at the telehealth site or in‐person at consultation. The participant must be able to complete the questionnaires (which are in English).