Feasibility and acceptability of a CF-specific cognitive-behavioral preventive intervention for adults integrated into team-based care

Deborah Friedman, Beth A. Smith, Amanda Bruce, Carolyn E. Schwartz, Hang Lee, Hanna Pinsky, Elizabeth Gootkind, Margot Hardcastle, Nicole Shea, Christine M. Roach, Caitlin Miller, Deepika Polineni, Matthias Salathe, Alexandra L. Quittner, Anna M. Georgiopoulos

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: A cystic fibrosis (CF)-specific cognitive-behavioral therapy intervention (CF-CBT) was developed in partnership with the CF community to advance preventive mental health care. Multidisciplinary providers across three centers were trained to deliver CF-CBT for this pilot assessing feasibility/acceptability and preliminary effectiveness of an integrated model of care. Methods: The 8-session CF-CBT was delivered to 14 adults with mild depression and/or anxiety symptoms in-person and via audio telehealth. Assessment of attrition, engagement, homework completion, treatment satisfaction, and treatment fidelity informed feasibility/acceptability assessment. Mental health outcomes included depression, anxiety, quality of life (Cystic Fibrosis Questionnaire-Revised [CFQ-R), perceived stress and coping. Preliminary effectiveness was evaluated with Cohen's d metric of effect sizes (ES) of pre-post mean change scores. Results: A total of 108 sessions were conducted; 13 adults completed the intervention; 1 discontinued early. Engagement, homework completion, and treatment acceptability were highly rated (mean = 30; SD = 2, range: 27–32 on a 32-point scale). Fidelity scores ranged from 85.7% to 93.6%. Large ES changes reflected improvements in depressive symptoms (−0.83), CFQ-R (Vitality scale: 1.11), and Relaxation Skills (0.93); moderate ES for CFQ-R Role Functioning (0.63), Awareness of Tension (0.62), Coping Confidence (0.70) and CF-specific Coping (0.55); and small ES for anxiety symptoms (−0.22), perceived stress (−0.25), Behavioral Activation (0.29), and several CFQ-R domains, including Emotional Functioning (0.29). Two CFQ-R subscales decreased (Body Image, Eating Concerns). Conclusions: Results indicated feasibility and acceptability of CF-CBT and its integration into team-based CF care with promising effectiveness, especially for depression. A multicenter randomized controlled trial of CF-CBT will further examine effectiveness of a CF-specific integrated care model.

Original languageEnglish
Pages (from-to)2781-2790
Number of pages10
JournalPediatric Pulmonology
Issue number11
StatePublished - Nov 2022


  • anxiety
  • cognitive-behavioral therapy
  • cystic fibrosis
  • depression
  • prevention
  • quality of life


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