Screening and treatment of psychological distress in colorectal cancer with metastasized disease: the TES-trial

Interventions: Targeted selection of patients with psychological distress. Enhanced care
by the clinical nurse specialist. Stepped care: The steps include: (i) Watchful waiting. (ii) If psychological distress persists, the guided self-help program. (iii) If psychological distress persists, a problem analysis is performed and an agreement is made with the patient on the next step; treatment consists of problem solving therapy (face-to-face). (iv) If psychological distress persists, psychotherapy, medication or a referral for other services (e.g. social work) is offered.
The TES intervention is compared to usual care.
Primary outcome(s): Psychological distress:
- Hospital Anxiety and Depression Scale (HADS)
Study Design: Randomized controlled trial, Single blinded (masking used), Active, Parallel