TY - JOUR
T1 - Integrating cognitive behavioral therapy into specialty care for adolescents with cystic fibrosis
T2 - a feasibility trial
AU - Friedman, Deborah
AU - Quittner, Alexandra L.
AU - Bruce, Amanda S.
AU - Smith, Beth A.
AU - He, Jianghua
AU - Chaudhary, Nivedita
AU - Boutwell, Abbey
AU - Wei, Ruobin
AU - Mullen, Tara M.D.
AU - Roach, Christine M.
AU - Behrman, Megan
AU - Georgiopoulos, Anna M.
N1 - Publisher Copyright:
© The Author(s) 2026. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected]. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
PY - 2026/5
Y1 - 2026/5
N2 - Objective: Created to advance cystic fibrosis (CF) mental health care delivery, CF-cognitive behavioral therapy (CBT) is being implemented across North America. An adolescent version (CF-CBT-A) was developed with stakeholder input. To assess the feasibility/acceptability of CF-CBT-A delivered via telehealth by CF care-team providers, we designed a one-arm feasibility trial at 3 CF Centers examining attrition, engagement, homework completion, and treatment satisfaction. Methods: Adolescents with CF identified by routine screening with at least mild depression and/or anxiety symptoms received CF-CBT-A. Retention rate (proportion enrolled completing all 9 sessions) and treatment satisfaction (proportion of Client Satisfaction Questionnaire-8 ratings above scale midpoint) were considered good at ≥70% and excellent at ≥80%. Pre–post change in measures of depression, anxiety, psychological stress, and coping (CF Coping Self-Efficacy; CF-CSE) were summarized with Cohen’s d metric of effect sizes. Results: Twelve participants (12–17 years; M = 13) enrolled, with 92% retention. Engagement was rated at the highest level, and homework was partially/fully completed for 94% and 74% of sessions, respectively. All adolescent and caregiver acceptability ratings were >Client Satisfaction Questionnaire-8 mid-point. Large effect sizes showed promising improvements in anxiety (−1.01) and coping: CF-CSE Relaxation Skills (2.00), Active Stress Management (1.09), and Acceptance/Communication (1.70). Effect sizes were moderate for depression (−0.64), CF-CSE Daily Self Care (0.68), and adolescent-reported psychological stress (−0.51). Effect sizes were small for caregiver-reported adolescent stress (−0.26). Conclusions: Results support the feasibility and acceptability of CF-CBT-A integrated into CF care, with preliminary evidence of positive impacts. Further research is needed to establish effectiveness and optimal implementation by CF teams to improve access to CF-specific evidence-based mental health care for adolescents.
AB - Objective: Created to advance cystic fibrosis (CF) mental health care delivery, CF-cognitive behavioral therapy (CBT) is being implemented across North America. An adolescent version (CF-CBT-A) was developed with stakeholder input. To assess the feasibility/acceptability of CF-CBT-A delivered via telehealth by CF care-team providers, we designed a one-arm feasibility trial at 3 CF Centers examining attrition, engagement, homework completion, and treatment satisfaction. Methods: Adolescents with CF identified by routine screening with at least mild depression and/or anxiety symptoms received CF-CBT-A. Retention rate (proportion enrolled completing all 9 sessions) and treatment satisfaction (proportion of Client Satisfaction Questionnaire-8 ratings above scale midpoint) were considered good at ≥70% and excellent at ≥80%. Pre–post change in measures of depression, anxiety, psychological stress, and coping (CF Coping Self-Efficacy; CF-CSE) were summarized with Cohen’s d metric of effect sizes. Results: Twelve participants (12–17 years; M = 13) enrolled, with 92% retention. Engagement was rated at the highest level, and homework was partially/fully completed for 94% and 74% of sessions, respectively. All adolescent and caregiver acceptability ratings were >Client Satisfaction Questionnaire-8 mid-point. Large effect sizes showed promising improvements in anxiety (−1.01) and coping: CF-CSE Relaxation Skills (2.00), Active Stress Management (1.09), and Acceptance/Communication (1.70). Effect sizes were moderate for depression (−0.64), CF-CSE Daily Self Care (0.68), and adolescent-reported psychological stress (−0.51). Effect sizes were small for caregiver-reported adolescent stress (−0.26). Conclusions: Results support the feasibility and acceptability of CF-CBT-A integrated into CF care, with preliminary evidence of positive impacts. Further research is needed to establish effectiveness and optimal implementation by CF teams to improve access to CF-specific evidence-based mental health care for adolescents.
KW - adolescents
KW - anxiety
KW - clinical trial
KW - cystic fibrosis
KW - depression
UR - https://www.scopus.com/pages/publications/105040686770
U2 - 10.1093/jpepsy/jsag006
DO - 10.1093/jpepsy/jsag006
M3 - Article
C2 - 41806380
AN - SCOPUS:105040686770
SN - 0146-8693
VL - 51
SP - 442
EP - 453
JO - Journal of Pediatric Psychology
JF - Journal of Pediatric Psychology
IS - 5
ER -