ORIGINAL ARTICLE Acceptability of an internet cognitive behavioural therapy program for people with early-stage cancer and cancer survivors with depression and/or anxiety: thematic findings from focus groups A. Karageorge 1 & M. J. Murphy 2 & J. M. Newby 2,3 & L. Kirsten 4,5 & G. Andrews 2 & K. Allison 5 & S. Loughnan 2 & M. Price 5 & J. Shaw 5 & H. Shepherd 5 & J. Smith 2 & P. Butow 5 Received: 29 September 2016 /Accepted: 6 February 2017 # Springer-Verlag Berlin Heidelberg 2017 Abstract Purpose We developed an eight-lesson internet-delivered CBT (iCBT) program targeting anxiety and depression in early-stage cancer and cancer survivors. To explore the ac- ceptability of the program, we showed volunteers the first two lessons and asked for their views. Methods Focus groups (n = 3) and individual interviews (n = 5) were undertaken with 15 participants (11 survivors) with mainly breast (11 of the 15) cancer, who had reviewed intervention materials. Participants were asked to consider the acceptability of the iCBT program content and implementa- tion design (timing, duration). Semi-structured questions guided discussion. Thematic analysis was conducted of par- ticipant reactions to the acceptability and/or suitability of ma- terials created for use in a psychological intervention. We took a data-driven (inductive) approach to semantic theme devel- opment across the data set. Results Participants reported high acceptability of the internet delivery format, good engagement and user-friendly material. Participants were broadly supportive of combining depression and anxiety iCBT resources for early-stage cancer patients and survivors. Participants further indicated that a separate course would be needed to address the needs of patients with ad- vanced stage disease. Conclusions Participants welcomed the general development of an internet-delivered CBT intervention program to treat pa- tients with clinical depression and/or anxiety. Furthermore, the sessions reviewed were highly acceptable to all participants. Study findings informed researchers on the development of iCBT resources for the cancer community. Keywords Cancer . Depression . Anxiety . Cognitive behavioural therapy (CBT) . Qualitative . Acceptability Introduction Rates of anxiety and depression are significantly higher in cancer patients and survivors than in the general population with point prevalence estimates of 12.9–20.7% for any mood disorder and 10.3–19% for anxiety disorders [1, 2]. Many suffer long-term emotional distress with symptoms of anxiety and depression persisting for years following completion of cancer treatment [3]. There is a need in routine cancer care to increase access to evidence-based interventions for depression and anxiety. An accepted best practice for these disorders is cognitive behavioural therapy (CBT), which has been shown to be an effective [4–6] and cost-effective intervention in the cancer context [7]. However, barriers to accessing face-to-face CBT Electronic supplementary material The online version of this article (doi:10.1007/s00520-017-3617-8) contains supplementary material, which is available to authorized users. * M. J. Murphy Michael.murphy@unsw.edu.au 1 Clinical Psychology Unit, School of Psychology, University of Sydney, 94 Mallett St, Camperdown, NSW 2050, Australia 2 Clinical Research Unit for Anxiety and Depression (CRUfAD), UNSW School of Psychiatry at St Vincent’ s Hospital, Level 4, O’Brien Centre, 394 Victoria Street, Sydney, NSW 2010, Australia 3 School of Psychology, Faculty of Science, UNSW Australia, Mathews Building, Kensington, NSW 2052, Australia 4 Nepean Cancer Care Centre, Sydney West Cancer Network, Kingswood, Sydney, NSW 2747, Australia 5 Psycho-oncology Co-operative Research Group (PoCoG), Level 6, Chris O’Brien Lifehouse (C39Z), The University of Sydney, Sydney, NSW 2006, Australia Support Care Cancer DOI 10.1007/s00520-017-3617-8