Trauma-Focused Managing Cancer And Living Meaningfully (CALM-TF) for Newly Diagnosed and Recurrent Ovarian Cancer
NCT ID: NCT07286162
Last Updated: 2025-12-16
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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NOT_YET_RECRUITING
PHASE3
300 participants
INTERVENTIONAL
2026-03-01
2031-12-31
Brief Summary
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The main questions it aims to answer are:
1. What is the effectiveness of CALM-TF in reducing traumatic stress symptoms in patients with newly diagnosed or recurrent advanced ovarian cancer, as measured at 3 and 6 months?
2. What are the effects of CALM-TF on depression, quality of life, and patient-perceived benefit of the intervention compared to usual care alone?
3. What are patient perceptions of their care experiences as explored through qualitative interviews?
Researchers will compare CALM-TF to usual standard of care (which includes regular conversations with medical teams and meetings with social workers) to see if CALM-TF works to treat traumatic stress.
Participants will:
* Receive 3-6 sessions of CALM-TF over 3-6 months (45-60 minutes each) via video call, telephone, or in-person based on preference, OR receive usual care only
* Complete questionnaires at baseline, 3 months, and 6 months
* Continue to receive their standard cancer care throughout the study
* Some participants may be invited to participate in qualitative interviews at 6 months
Detailed Description
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Traumatic stress refers to the psychological impact of traumatic events, which in cancer care includes the diagnosis, progression, or recurrence of advanced disease. Research shows that up to 45% of patients with ovarian cancer experience clinically significant traumatic stress symptoms that meet diagnostic criteria for acute stress disorder.
CALM-TF is a manualized psychotherapeutic intervention that builds on an established therapy called CALM (Managing Cancer and Living Meaningfully), which has previously been shown to reduce depression and improve communication with healthcare providers in patients with advanced cancer. CALM-TF incorporates trauma-focused components specifically designed to address traumatic stress symptoms that arise at the time of diagnosis or recurrence of ovarian cancer.
The intervention consists of 3-6 individual therapy sessions delivered over 3-6 months, with each session lasting 45-60 minutes. Sessions can be conducted via secure video conferencing, telephone, or in-person based on participant preference. The therapy focuses on four interconnected content areas: symptom management and communication with healthcare providers; changes in self and relationships with close others; sense of meaning and purpose in life; and hopes and fears about the future and mortality, with trauma-focused components integrated throughout.
This is a multi-site randomized controlled trial enrolling 300 women with newly diagnosed stage III or IV ovarian cancer or recurrent ovarian cancer (within six months of diagnosis or recurrence). Participants are randomly assigned in a 1:1 ratio to receive either CALM-TF plus usual care or usual care alone. Usual care includes regular conversations with medical teams and meetings with social workers regarding financial or practical issues, with access to specialized psychological support through referral.
The study uses validated questionnaires to measure traumatic stress symptoms, depression, quality of life, death anxiety, and perceived benefit of care at three time points: baseline, 3 months, and 6 months after enrolment. The primary outcome is traumatic stress symptoms at 6 months measured by the Stanford Acute Stress Reaction Questionnaire-II (SASRQ-II), a 30-item instrument with scores ranging from 0-150, where scores above 40 indicate clinically significant symptoms.
A subset of up to 30 participants will be invited to participate in qualitative interviews after completing their 6-month assessment to share their experiences with the intervention or usual care, explore factors that influenced their traumatic stress experience, and discuss how the therapy was integrated into their daily lives. The study also includes a health economic evaluation to assess the cost-effectiveness of CALM-TF compared to usual care over the 6-month period.
The findings of this RCT will inform healthcare policy and clinical practice guidelines for comprehensive psychosocial care, with potential for CALM-TF to be integrated into standard care.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
SUPPORTIVE_CARE
SINGLE
Study Groups
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CALM-TF plus Usual Care
Participants receive Trauma-Focused Managing Cancer and Living Meaningfully (CALM-TF), a brief manualized psychotherapeutic intervention consisting of 3-6 individual sessions over 3-6 months (45-60 minutes each). Sessions delivered via secure video conferencing (Microsoft Teams), telephone, or in-person based on participant preference. Participants also continue to receive usual standard of care throughout the intervention period.
Trauma-Focused Managing Cancer and Living Meaningfully
CALM-TF is a brief, manualized psychotherapeutic intervention that incorporates trauma-focused elements into the established CALM framework. It includes a present-oriented focus with particular attention to affect regulation, relational support, and attachment security, specifically designed to address traumatic stress symptoms triggered by a diagnosis or recurrence.
The intervention consists of 3-6 sessions delivered over 3-6 months, with each session lasting 45-60 minutes. Sessions are delivered by trained therapists through multiple modalities including secure web-conferencing software (Microsoft Teams), telephone, or in-person visits based on patient preference.
CALM-TF focuses on four broad and interconnected content domains: (1) symptom management and communication with healthcare providers; (2) changes in self and in relationships with close others; (3) sense of meaning and purpose in life; and (4) hopes and fears about the future and mortal
Usual Care Alone
Participants receive usual standard of care only, which includes frequent conversations with their medical team regarding their care and meetings with social workers regarding financial or other practical issues. Participants have access to formal or specialized psychotherapeutic interventions upon referral by their primary physician or member of their circle of care.
No interventions assigned to this group
Interventions
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Trauma-Focused Managing Cancer and Living Meaningfully
CALM-TF is a brief, manualized psychotherapeutic intervention that incorporates trauma-focused elements into the established CALM framework. It includes a present-oriented focus with particular attention to affect regulation, relational support, and attachment security, specifically designed to address traumatic stress symptoms triggered by a diagnosis or recurrence.
The intervention consists of 3-6 sessions delivered over 3-6 months, with each session lasting 45-60 minutes. Sessions are delivered by trained therapists through multiple modalities including secure web-conferencing software (Microsoft Teams), telephone, or in-person visits based on patient preference.
CALM-TF focuses on four broad and interconnected content domains: (1) symptom management and communication with healthcare providers; (2) changes in self and in relationships with close others; (3) sense of meaning and purpose in life; and (4) hopes and fears about the future and mortal
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Age 18 years or older
* Able to speak and read English
* Able to provide informed consent
Exclusion Criteria
* Active psychosis or severe psychiatric condition requiring immediate psychiatric intervention
* Receiving ongoing psychotherapy at the time of recruitment
18 Years
FEMALE
No
Sponsors
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University Health Network, Toronto
OTHER
Responsible Party
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Principal Investigators
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Stephanie Lheureux, MD-PhD
Role: PRINCIPAL_INVESTIGATOR
University Health Network, Toronto
Gary Rodin, MD
Role: PRINCIPAL_INVESTIGATOR
University Health Network, Toronto
Locations
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Princess Margaret Cancer Centre
Toronto, Ontario, Canada
Countries
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Central Contacts
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Facility Contacts
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Other Identifiers
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OZUHN-045
Identifier Type: -
Identifier Source: org_study_id