Table 2.

Psychologist-delivered interventions

Study	Settings/Patients	Study Design/Intervention	Timing of intervention	Assessment timepoints	Measures	Results	Methodological Quality
Hammerlid et al. (1999) [20]	13 HNC pts. in Sweden	Single arm studies. Two studies: first, long term psychological group therapy for patients with newly diagnosed HNC with psychologist. Second, 1 week long psychoeducational program 1 year after treatment for HNC with oncologist, nurse, and physiotherapist.	1. Started with new diagnosis of HNC; 2. Started 1 year after treatment	baseline, 1, 2, 3, 6, and 12 months	HADS; EORTC; study-specific questionnaire	QOL in therapy group improved more than control	3
Allison PJ et al. (2004) [21]	50 HNC pts.; Canada	Single arm study. Intervention group received Nucare coping strategies, psychoeducational intervention that teaches coping in one of three formats (small group with therapist, one on one with therapist, or a home format without therapist)	no information about where patients were in treatment or type of treatment or subtype of HNC	baseline and 3 months	EORTC-QOL; HADS	Intervention resulted in higher health related QOL and depression scores.	5
Kangas et al. (2013) [22]	35 HNC pts. with elevated levels of PTSD, depression, or anxiety	RCT. Intervention group received seven weekly individual sessions with clinical psychologist of multi-modal CBT vs non-directive supportive counseling, concurrent with patient’s radiotherapy.	concurrent with radiotherapy	baseline, 1, 6, and 12 months	Clinician Administered PTSD Scale; Beck Depression Inventory; State Trait Anxiety Inventory; FACT-General	CBT and SC interventions found to be equal in effects reducing PTSD and anxiety symptoms in short/long term. However, more pts. in CBT program no longer met clinical or sub clinical PTSD, anxiety, and/or depression by 12 months post treatment	5
Kilbourn et al. (2013) [28]	24 HNC pts.	Single arm study. Easing and Alleviating Symptoms during Treatment (EASE) intervention – participants received up to 8 telephone counseling sessions focused on coping and stress management.	Concurrent with radiotherapy	Baseline, 1 month post intervention end	Impact of Events Scale, FACT-HN, Pain Disability Index, Interpersonal Support Evaluation List	Intervention was feasible and acceptable. Participants experienced decrease in QOL and no change in pain scores.	4
Krebber et al. (2016) [23]	156 pts. (HNC and lung cancer (LC)); had distress on HADS to be included; Netherlands	RCT. Intervention group received stepped care, which consisted of watchful waiting, guided self-help, problem-solving therapy, and psychotherapy and/or psychotropic medication with oncologist or psychologist/psychiatrist as stepped care.	enrolled within 1 month of completing curative treatment for LC or HNC (94%), no specifics on surgery vs. RT vs CRT	baseline, completion of care, 3, 6, 9, 12 months	HADS; EORTC QLQ-C30, QLQ-HN35/QLQ-LC13, IN-PATSAT32 (satisfaction with care)	Psychological distress better in the stepped care group vs usual care. Those patients with anxiety or depression had an even larger improvement in the stepped care group.	6
Pollard et al. (2017) [29]	19 HNC pts.	Single arm study. Mindfulness intervention – participants received 7, 90 min one-on-one sessions with clinical psychologist with individualized mindfulness-based stress reduction (IMBSR) program.	Concurrent with radiotherapy	Baseline and post-intervention/ treatment	Five-Factor Mindfulness Questionnaire (FFMQ), Profile of Mood States-Short Form, FACT-HN	Intervention was feasible and acceptable with good patient-compliance. QOL declined over the intervention for the whole population, however, patients with higher post-intervention mindfulness had higher QOL.	4