Effects of cognitive behavioral therapy on resilience among adult cancer patients: a systematic review and meta-analysis

Abstract Background Psychological resilience refers to maintaining or regaining psychological well-being after experiencing adversity, trauma, or stress. There is evidence suggesting that cognitive behavioral therapy (CBT) can significantly enhance an individual’s coping skills. However, the overall effectiveness of CBT on resilience among cancer patients remains unclear. Therefore, this study systematically evaluated the impact of CBT on resilience among cancer patients. Methods The PubMed, PsycINFO, Cochrane Library, CINAHL, and Embase databases were searched using keywords. Two researchers independently conducted a rigorous evaluation of the quality of the evidence using the GRADE system and independently performed data extraction. A meta-analysis was conducted to calculate the experimental group's effect size and to explore the effects of CBT on enhancing resilience. Results Thirteen randomized controlled trials (RCTs) were included in this meta-analysis. The effect of CBT on increasing resilience among cancer patients was small but significant immediately after the intervention (g = 1.211; p < 0.001). The results showed that CBT delivered via mobile devices was more effective than face-to-face CBT (β = 0.284; P = 0.012). Additionally, group CBT also outperformed individual CBT (β = 0.181; P = 0.042). Furthermore, CBT was more effective among patients with existing tumors (β = 0.285; P = 0.037). The evidence regarding the effects of CBT on resilience was found to be of moderate strength. Conclusions The results of this study indicate CBT can improve resilience among cancer patients. These findings underscore the importance of considering delivery methods and formats when implementing CBT interventions, with mobile device delivery and group formats resulting in better outcomes. The positive effects of CBT on patients with existing tumors highlight the importance of delivering this therapy in specific clinical contexts. Overall, this study provided moderately strong evidence that CBT is a valuable tool for enhancing resilience among cancer patients. Trial registration CRD42021256841.