On-Trac: An Online Intervention for Cancer Survivors Managing Anxiety

Inclusion Criteria:

* Age ≥ 18
* A diagnosis of cancer (except non-melanoma skin cancer) ≥ 12 months prior.
* No active cancer therapy (excluding chemoprevention) in the past 4 months, and no further therapy planned.
* Significant anxiety as evidenced by both of the following

  * Endorsement of the SCID ( Structured Clinical Interview for the DSM-5) Screener Items for Social Anxiety Disorder, Generalized Anxiety Disorder, Agoraphobia, Specific Phobia, or Illness Anxiety Disorder.
  * A score ≥ 6 on the Overall Anxiety Severity and Impairment Scale (OASIS).
* Regular access to the internet.
* Ability to read and write in English.

Exclusion Criteria:

* Significant symptoms of Panic Disorder in the prior month, including anticipatory anxiety of having a future panic attack or avoidance symptoms associated with panic attacks, as assessed by three SCID-5 items from the panic attack disorder module.
* Significant symptoms of Obsessive Compulsive Disorder, as evidenced by any obsessions over the past 3 months, as assessed by three SCID items from the Obsessive Compulsive Disorder module.
* Psychiatric hospitalizations or emergency room visits for psychiatric care in the prior 2 years.
* In the next two months, intention to use or likelihood of using emergent or "rescue" anxiety medication (e.g., Ativan, Xanax, Valium) or self-prescribed substances (i.e., marijuana) at the onset of anxiety symptoms or when entering a situation where they expect to experience anxiety.
* Any significant marijuana use which could impact anxiety symptoms, as evidenced by one of the following:

  * 4 days of marijuana use in any week in the last month
  * 20 milligrams of THC (Tetrahydrocannabinol) products in any week in the last month.
* Participation in any CBT or ACT-based behavioral or education intervention for anxiety in the past 2 years. This includes in-person, asynchronous, and synchronous online anxiety programs, and therapy that includes these skills. This does not include independent use of any self-help materials (i.e., workbooks, books).
* Any impairment (e.g., hearing, visual, cognitive) that interferes with the ability to complete all parts of the study independently.