Introducing psychology services to advanced cancer patients: A randomized double-blind trial

Context: Psychology services utilization in cancer patients remains low due to barriers such as patient/caregiver acceptance of counseling. Objective: We aimed to determine if the manner of introducing psychology services impacted patients' acceptance of services and to identify factors associated with acceptance and barriers to psychology utilization. Methods: In this double-blind randomized cross-over trial, cancer patients with no prior psychology services observed two video vignettes: (a) physician introducing counselor and psychology services to the patient (PI) and (b) counselor introducing psychology services alone (CI). A counterbalanced design was used to control for order effects. After viewing both videos, patients completed a survey regarding preference, attitudes, and barriers for psychology services. Patients and investigators were blinded to the purpose of the study and content and order of videos, respectively. We hypothesized that patients would prefer physician introduction of counselor. Results: One hundred patients participated: 40 (40%) expressed no difference, 34 (34%) preferred PI, and 26 (26%) preferred CI (P '.2). Younger patients (less than 40 years) either preferred PI (86%) or had no preference (14%, P =.01). Most reported awareness of available psychology services (N = 63), and half (N = 50) were offered psychology services by their physician. Only 40 (40%) and 43 (43%) patients felt psychology services would be helpful for them and their family/caregivers, respectively. Patients who perceived psychology as helpful for self or family had higher anxiety (P =.01 and P =.006, respectively). Conclusions: No significant difference was found in patient preference of introducing psychology services except in patients less than 40 years old who preferred PI.