STREAM - actively reduce stress

STREAM (STREss-Aktiv-Mindern) is an online program for dealing with psychological stress in the context of cancer. The aim of the program is to increase quality of life and improve stress management.

To the portal stress-aktiv-mindern.ch (Login)

The program

For most people affected by cancer, the diagnosis means a serious change in their lives. The online program STREAM (Stress Aktiv Mindern) is designed to offer support in this difficult phase of life in dealing with the many burdens that you are confronted with as an affected person.

Study results

The STREAM program was tested as a randomized controlled clinical trial (intervention group vs. wait-and-see control group). The results showed a significant increase in quality of life as well as a reduction in stress. The results were published in the renowned Journal of Oncology (Grossert/Urech et al. 2018).

The team

STREAM Version 2.0 - after the successful testing of the program, it is our concern to make the program accessible to you again. We look forward to hearing from you and to your participation.

The program

For most people affected by cancer, it means a serious turning point in their lives. It can turn a life upside down in a very short space of time. Many things are no longer as they were before. In this difficult phase of life, the online program is intended to offer support in dealing with the many burdens that you as the affected person are confronted with.

STREAM stands for STREss Aktiv Mindern.

STREAM is an eight-week online program developed by psychologists and oncologists especially for people with cancer undergoing treatment.
Based on information, exercises and specific instructions from the field of clinical psychology (cognitive-behavioral therapy and mindfulness/acceptance-based techniques as well as
acceptance-based techniques and relaxation methods), you will be shown ways of coping with cancer.

Are you eligible for this program?

If you have any questions about the participation criteria, please contact us.

You are over 18 years old
You are suffering from cancer
You have good written and spoken German skills
You have access to a computer/laptop/ipad and basic computer skills

The program lasts 8 weeks. You will work on one module per week (processing time approx. 1-2 hours plus recommended daily practice time of approx. 30 minutes). The program will provide you with information and you will learn exercises and strategies to help you manage stressful situations caused by illness more effectively.

Your support person will contact you in writing on a weekly basis. If you have technical or content-related difficulties with the program, you can contact your supervisor in writing at any time during the program.

Each exercise module is divided into three parts:

Reading & understanding
Observe & discover
Trying out & experiencing

Effectiveness

The effectiveness of STREAM was investigated in a study. Read more about the study results below.

Billing

The time spent by the supervising psychologist is billed via the health insurance company (basic insurance).

Please note

This is an online program with occasional written contact with a therapist. Due to the time delay in reading emails, STREAM cannot provide 24-hour help in the event of a mental health crisis.

Note

During the initial telephone contact, you will be asked to write down your individual emergency numbers or save them in your cell phone. This means that you do not have to search for the numbers for a long time in an emergency situation.

Internet-based approaches are not suitable for responding appropriately to crisis situations due to local distance and time delays in communication (e.g. email). We are not available 24 hours a day and would therefore like to draw the attention of those affected to important addresses in Switzerland, Germany and Austria. STREAM is a supportive, tested self-help program with contact to a psychotherapist.

If you have specific questions about your medical situation, please contact your doctor.

In medical emergency situations, please contact the emergency treatment center or the nearest hospital.

You can find information on cancer on the following websites

Swiss Cancer League krebsliga.ch
German Cancer Aid krebshilfe.de
Austrian Cancer Aid Vienna krebshilfe-wien.at

Modules of the program

Module 1: Introduction. What is stress? Dealing with stress

In this module you will learn about the different components that are needed to feel stress or strain. You will get to know the stress protocol, which will help you to break down these individual components.

Exemplary view of the stress protocol

Module 2: Stress regulation at body level

The stress caused by cancer also manifests itself on the physical side, for example through pain or fatigue. In this module, you will be shown ways of dealing with your physical stress.

Module 3: Stress regulation at the level of thoughts

This is about your thoughts and thought worlds. You will learn various strategies for dealing with stressful thoughts in connection with your cancer.

Audio sample Man with the hammer (mp3)

Module 4: Stress regulation at the emotional level

The focus is on feelings. The aim is to shed light on your own emotional world and find out what your current feelings stand for. Is there a message behind the feelings? In this module, you will also learn strategies for dealing better with stressful feelings.

Module 5: The concept of mindfulness and acceptance

This module is dedicated to mindfulness and acceptance of thoughts and feelings.

Excerpt from the section: Reading & Understanding

Module 6: Activating resources: quality of life & enjoyment

This module focuses on activating your resources, your sources of strength and the topic of enjoyment.

Module 7: Resource activation: My social network & communication

The module takes a look at the resources in your social environment. The aim is to recognize from which social contacts you draw strength to deal with the illness.

Module 8: Closing session and summary

Review of the online program. The online stress management program ends with the eighth module.

Study results

Overview of the most important results

The quality of life measured with the FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue) was significantly higher in the intervention group than in the control group (ANCOVA, p=0.007) measured after the intervention. The most significant improvements were seen in the subscales 'Fatigue', 'Physical Wellbeing', and 'Functional wellbeing'.
Patients in the intervention group had significantly lower stress levels than patients in the waiting group (measured with the German version of the NCCN Distress Thermometer) (p=0.03).
The effectiveness of the STREAM program is also underlined by the high clinical relevance of the results.

Articles & prices (all articles can be found in the Echo section)

Study protocol: Grossert, A., Urech, C., Alder, J., Gaab, J., Berger, T., & Hess, V. (2016). Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study. BMC Cancer, 16(1), 838,
Main results: Urech, C.*, Grossert, A.*, Alder, J., Scherer, S., Handschin, B., Kasenda, B., Borislavova, B.,Degen, S., Erb, J., Faessler, A., Gattlen, L., Schibli, S., Werndli, C., Gaab, J., Berger, T., Zumbrunn, T., & Hess, V. (2018). Web-Based Stress Management for Newly Diagnosed Patients With Cancer (STREAM): A Randomized, Wait-List Controlled Intervention Study. J Clin Oncol, 36(8), 780-788 * equal contributors
Technical testing of the intervention: Grossert, A., Heinz, S., Müller, L., Gaab, J., Urech, C., Berger, T., & Hess, V. (2019). Usability Testing of the Online Stress Management Intervention (STREAM) for Cancer Patients: Results and Implementations. Cancer Stud Ther J, 4(2), 1-5.
2018 Reinhold-Schwarz Prize, awarded by the Association for Continuing Education and Training in Psychosocial Oncology (WPO) and the German Cancer Society's Working Group for Psychooncology (PSO)

Outlook and conclusion

Our results show that a web-based, "minimal-contact" stress management program is an attractive, effective and also time- and cost-effective way to offer psycho-oncological support to cancer patients. A major advantage is the flexibility in terms of time and location as well as the lack of waiting times for a therapy place. It can also reach patients who live far away from treatment centers, for example. The aim of the STREAM 2.0 version of this program is to make it accessible to patients outside of a study.

Team