D South America, Europe, the Middle East, Asia and Africa. Trial Registration: ClinicalTrials.gov NCT01506492 four January 2012. Keyword phrases: Advanced PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/21296415 cancer, Psychotherapy, Randomized controlled trial Correspondence: gary.rodinuhn.ca 1 Department of Supportive Care, Princess Margaret Cancer Centre, University Well being Network, 16th Floor, 610 University Avenue, Toronto, ON M5G 2M9, Canada two Division of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, ON M5T 1R8, Canada Full list of author info is out there at the end on the article2015 Lo et al. Open Access This article is distributed beneath the terms of the Creative Commons Attribution 4.0 International License (http:creativecommons.orglicensesby4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided you give proper credit for the original author(s) plus the supply, present a hyperlink to the Creative Commons license, and indicate if changes were produced. The Inventive Commons Public Domain Dedication waiver (http:creativecommons.orgpublicdomainzero1.0) applies for the data made available in this article, unless otherwise stated.Lo et al. Trials (2015) 16:Page 2 ofBackground Advanced or metastatic cancer is predictably linked with challenges and burdens that might bring about symptoms of depression and demoralization and fears of suffering, dependency, and mortality [1]. The many physical symptoms, the dramatic alteration in support wants and in individual relationships, the difficulty navigating a complex wellness care system, along with the threat of impending mortality all may perhaps constitute pathways to distress in this population [2]. The challenge for men and women in this circumstance is to sustain a “double awareness” that enables them to remain engaged in life even though facing the imminence of physical deterioration, shortened survival, and death [3]. A number of individual and social variables could defend individuals in this circumstance, but skilled assistance may well also be of value to prevent and treat the distress that frequently emerges within this population [4]. Clinically substantial depressive symptoms could be frequent in sufferers with sophisticated cancer and may be understood as a final typical pathway of distress, emerging in response to the interaction of numerous disease-related, individual and psychosocial elements [1, two, 5]. The most prominent of these would be the physical burden of disease, attachment insecurity (i.e., worry concerning the availability of supportive relationships and also the capacity to make use of them for WCK-5107 Formula emotional support), reduced self-esteem, feelings of hopelessness and impaired spiritual well-being [1, 2]. Although quite a few psychotherapeutic modalities have already been employed to treat depression (e.g., cognitive behavior therapy and interpersonal therapy), positive outcomes and sustained improvement could possibly be most likely when treatment is directed at etiological and pathogenic aspects which might be particular to the context in which disturbances arise [8]. Preliminary findings in patients with advanced cancer also recommend that psychological treatment options for depression are preferred more than pharmacological ones [9], and that person psychotherapy is preferred more than group therapy since sessions is usually flexibly tailored to patients’ individual demands, taking into account other clinic appointments and fluctuations in well being status [103]. To address the relative lack of evidence-based individual therapies tailored for this population, we have developed a novel.