Addressing psychological needs of breast cancer patients with cognitive behavioural therapies: A targeted literature review from in person to digital interventions

Breast cancer and its treatment can cause substantial psychological distress, with depression, anxiety, and stress being the most prevalent challenges reducing quality of life. Although Cognitive Behav- ioural Therapy (CBT) is proven to be effective, access to psychological support remains a critical issue as public health systems often struggle to provide adequate care. This gap has prompted explo- ration into how technology can improve access to psycho-oncological support. Digital Mental Health Interventions (DMHIs) are increasingly used for psychological care, but a significant challenge is that many of these applications lack scientific validation. This systematic review evaluates the utilization and effectiveness of CBT and CBT-derived interven- tions targeting depression, anxiety, and stress, either as primary or secondary outcomes, delivered via digital therapeutics (DTx), online, traditional (in-person), and hybrid (online plus in-person) formats among women with breast cancer. Following PRISMA guidelines, a systematic search was conducted across four major databases up to January 2023, identifying English-language studies on CBT efficacy. After screening 1,172 records, 96 articles were selected for qualitative analysis. The included studies, published between 1996 and 2022, were predominantly Randomized Controlled Trials (RCTs). By categorizing interventions by delivery method, this review aims to highlight effective support strategies and inform future research and clinical practice in psycho-oncology. Results confirm the significant efficacy of CBT in improving anxiety, stress and depression among women with breast cancer. Ongoing research on digital and online CBT formats demonstrates con- siderable potential, addressing accessibility problem and reducing psychological distress though clas- sic CBT continues to be the most extensively researched.