From clinical trials to studies of daily life, these are the studies our lab runs and the projects we work on with other research teams.
Trials
Studies that test whether a treatment or program helps people.
SleepSteps
SleepSteps is a randomised controlled trial of stepped care for insomnia in people with cancer. Sleep problems are common during and after cancer treatment. Cognitive behavioural therapy for insomnia (CBT-I) is the best treatment available, but there are not enough trained clinicians to offer it to everyone who needs it. SleepSteps tests a more scalable approach in two stages. First, people are randomly assigned to a self-management program (short, cancer-specific videos on a website, with text-message prompts) or to a waitlist. Then, people who are still having trouble sleeping are randomly assigned either to step up to brief CBT-I with a therapist by telehealth, and to specialist care at the Monash University Healthy Sleep Clinic if needed, or to keep going with self-management. The trial asks two questions: does stepped care improve sleep, and could health services run it as part of routine care? People with lived experience of cancer are part of the core research team and help shape the program. Recruitment through cancer centres (including the Peter MacCallum Cancer Centre and Monash Health), community organisations and social media is expected to start in 2027. SleepSteps is funded by a National Health and Medical Research Council (NHMRC) Investigator Grant (2043220) to Joshua Wiley.
CanCope
The CanCope Study was an online trial that aimed to help people who have had cancer cope with difficult emotions and improve their mental health. Many people affected by cancer continue to experience distressing emotions after treatment has finished. CanCope tested an emotion-focused, transdiagnostic online program and explored how it changes emotion regulation and symptoms of anxiety and depression. Each module was first piloted on its own (Smith et al., 2022). Then, in a randomised controlled trial with 224 cancer survivors, the emotion-focused program improved most of the emotion regulation skills it targeted more than a healthy lifestyle program did (Smith et al., 2023), and quality of life improved in both groups (Wallace et al., 2025). CanCope was led by Dr Isabelle Smith as part of her doctorate.
This clinical trial is registered ACTRN12620000943943p with ethics approved by Monash University.
SleepCare
The Sleep, Cancer and Rest (SleepCaRe) Trial was a parallel-group, randomised controlled efficacy trial that evaluated individual and combined interventions for sleep and fatigue during chemotherapy. Individuals undergoing chemotherapy are placed at an increased risk of sleep-related disturbance and daytime fatigue. Despite this, sleep concerns among individuals with cancer are often unrecognised and inadequately managed. In 219 women having chemotherapy for breast cancer, brief cognitive behavioural therapy for insomnia (CBT-I) improved insomnia symptoms, but not fatigue, more than treatments without it, and bright light therapy gave no extra benefit for either (Do et al., 2026). CBT-I was also linked to clinically meaningful improvements in quality of life during chemotherapy (Wallace et al., 2026). The SleepCaRe Trial was conducted as part of a collaboration between Monash University, the Peter MacCallum Cancer Centre, Monash Health, Bendigo Health, Grampians Health (Ballarat), and the Mater Hospital North Sydney.
This clinical trial is registered ACTRN12620001133921 with ethics approved by the Peter MacCallum Cancer Centre.
SleepWell
The SleepWell Trial was a randomised controlled trial of a brief treatment to improve sleep and reduce fatigue in women with breast cancer, designed to be feasible for widespread dissemination. Women with breast cancer commonly report sleep disruptions and fatigue, particularly during chemotherapy. In 101 women having chemotherapy, brief cognitive behavioural therapy for insomnia plus bright light therapy improved insomnia and fatigue more than usual care plus relaxation audio by the end of the six-week program (Bean et al., 2022). SleepWell was conducted as a collaboration between Monash University and the Victorian Comprehensive Cancer Centre, with recruitment and intervention at the Peter MacCallum Cancer Centre. SleepWell was led and conducted by Dr Helena Bean as part of her doctorate. SleepWell was completed in 2020.
For more info, read the Explanatory Statement.
This clinical trial is registered ACTRN12618001255279.
Observational studies
Studies that learn from people’s experiences, without testing a treatment.
Distress Management in Oncology
This project looked at how psychological distress is identified and managed for people having outpatient cancer treatment, including in chemotherapy day units. It drew on hospital records, focus groups with oncology staff and patients’ experiences to describe current practice and how it could be improved. More than half of the patients screened reported clinically significant distress, but few referrals after screening addressed psychological concerns directly (Matthews et al., 2026). Staff saw a clear need for mental health support during treatment, but described a lack of cancer-specific mental health services, limited time and unclear responsibilities (Matthews et al., 2025). The project was led by Dr Elizabeth Matthews as part of her doctorate.
Testicular Cancer and Masculinities
This mixed-methods project looked at how testicular cancer (TC) and its treatment affect men’s sense of masculinity, and how this relates to psychological distress, in men in Australia. Despite a high survival rate (~98%), TC is associated with psychological distress, including fear of cancer recurrence, depression and anxiety. A systematic review found that some men feel less masculine after TC, but that the impact differs from person to person (Dax et al., 2022). In a survey of 92 men with TC and 90 men without cancer, the two groups reported similar masculinity and distress, but among men with TC, holding back emotions and affection, work–family conflict and stress about their masculinity were linked to more distress (Dax et al., 2024). In interviews with 21 men, keeping emotional control, strength and physical function mattered to how they saw themselves as men, and holding rigidly to traditional norms when these were threatened was linked to distress (Dax et al., 2024). The project was a collaboration between Monash University and the Peter MacCallum Cancer Centre, led by Dr Victoria Dax as part of her doctorate.
Daily life studies
Studies that follow sleep, stress, mood and activity day by day, as people go about their lives.
Stress and Health Study
Many young adults move states or countries to start their university or college studies. During this time, they face many changes: new independence from family, moving and living in a new city, and new courses and studies. All these changes can cause stress. The Stress and Health Study (SHS) aimed to understand how young adults respond to stress during these transitions and what helps people manage stress. The study focused on how family experiences, resilience, behaviours (diet, exercise, sleep), and coping strategies relate to stress and how people feel. Nights of shorter or poorer sleep were followed by more stress the next day (Yap et al., 2022), and students from difficult family backgrounds who were more resilient reported less daily stress and negative emotion than those who were less resilient (Tung et al., 2022). SHS was completed in 2020.
For more info, read the Explanatory Statement.
DESTRESS
The Diet, Exercise, Stress, Emotions, Speech, and Sleep study (DESTRESS) was a 7-day daily diary study in 135 adults using ecological momentary assessment to examine behavioural (diet, sleep, physical activity) and psychological (stress, emotions, psychosocial vulnerabilities) factors. DESTRESS replicated findings from our previous ACES study and extended it by examining the daily dynamics of sleep and psychological factors with diet. A unique feature of DESTRESS was the collection of qualitative data on stress experiences through brief recorded speech throughout the day. Across DESTRESS, ACES and our Stress and Health Study, people who tended to cope by disengaging reacted to daily stress with somewhat more negative emotion (Sun et al., 2023). DESTRESS was completed in 2018; we continue to publish findings from these data.
For more info, read the Explanatory Statement.
To learn about the results, read What We Learned, our report to participants in the lab’s 2016–2018 daily studies.
ACES
The Activity, Coping, Emotions, Stress and Sleep (ACES) study was a 12-day daily diary study in 191 adults using ecological momentary assessment to examine behavioural (sleep, physical activity) and psychological (stress, emotions, psychosocial vulnerabilities) factors. Using high-quality, objective data, ACES and our later DESTRESS study showed that daily stress and sleep are linked in both directions: higher evening stress was followed by shorter sleep, and shorter or poorer sleep by more stress the next day (Yap et al., 2020). ACES was completed in 2017; we continue to publish findings from these data.
For more info, read the Explanatory Statement.
To learn about the results, read What We Learned, our report to participants in the lab’s 2016–2018 daily studies.
Other studies
Other research our lab leads, including programs of work that span several studies.
NHMRC Investigator Grant
Optimising treatment to reduce sleep and depression symptoms in cancer: A personalised medicine approach
Diagnosis and treatment of cancer place an enormous strain on individuals, with particularly harmful effects on sleep and depression. Although multiple evidence-based treatments exist for both sleep problems and depression, up to 50% of people do not respond to first-line treatments. Matching each person to the treatment most likely to work for them can improve outcomes by shortening the time it takes to find one that works. This is particularly important in cancer, where patients have limited energy to engage in treatment and the growing number of people living with cancer taxes limited health care resources.
This NHMRC Investigator Grant (Emerging Leadership 1) to Joshua Wiley supported our work on personalised treatment: methods that combine a person’s characteristics to predict which treatment is likely to help them most (for example, when choosing between two treatments for PTSD: Stirman et al., 2021), and new, brief trials of sleep and mental health treatments for people with cancer. In the SleepCaRe trial, six weeks of cognitive behavioural therapy for insomnia (CBT-I) during chemotherapy for breast cancer improved insomnia symptoms (Do et al., 2026) and quality of life (Wallace et al., 2026). The grant also supported free, open-source R software for our statistical methods (Le et al., 2026).
Projects we collaborate on
Studies led by other research teams, in which our lab is a partner.
COPE
The COVID-19 Outbreak Public Evaluation (COPE) Initiative assesses public attitudes, behaviours and beliefs related to the COVID-19 pandemic, and the pandemic’s consequences for mental and behavioural health.
Its goal is to give the public a voice by sharing findings that help shape public health communication and interventions.
The Behavioural Medicine Lab collaborates on several COPE projects. In a June 2020 survey of US adults, 41% reported at least one mental or behavioural health concern, such as symptoms of anxiety or depression, and 11% had seriously considered suicide in the previous month (Czeisler et al., 2020).
Find out more at the COPE Initiative website.
CLASS/MYSLEEP
Over 70% of adolescents in Australia experience insufficient sleep. Yet, the extent to which the biological clock in the brain plays a role in cognitive function and academic functioning is currently not understood. The Circadian Light in Adolescence, Sleep and School (CLASS) study is a longitudinal cohort study led by Monash University and Professor Bei Bei. CLASS uses state-of-the-art measures of the biological clock, rigorous assessment of light exposure and sophisticated analytical approaches (study protocol). It examines how light exposure and multiple facets of sleep and wakefulness relate over time to academic achievement and depression, to identify sleep and circadian markers linked to academic performance and develop algorithms that predict these links. Analyses led by our lab found that teenagers who felt stronger positive emotions day to day had fewer depression and anxiety symptoms two years later (Sun et al., 2026). Findings from CLASS can help drive prevention and early intervention programs that use sleep-wake and light exposure information to improve sleep quality. CLASS has been funded by the ARC and NHMRC to allow further longitudinal follow-up.
MYSLEEP (Mapping Youth Sleep, LifestylE, and Emotions Project) extends CLASS. It is an international effort spanning Australia, the United States, the United Kingdom, Malaysia and South Africa that aims to identify the biological, psychological, social and environmental factors contributing to sleep and circadian rhythm disturbances in young people, to guide prevention and intervention for depression and anxiety. MYSLEEP partners with people with lived experience and engages young people throughout the research. It draws on existing data from leading sleep and circadian research groups and collects new longitudinal data from young people in Australia, Malaysia and South Africa, to adapt and validate the models locally as they move from secondary school into tertiary education and work. MYSLEEP is recruiting 16- to 20-year-olds and following them up to age 18–22. It is funded by Wellcome (2024–2029; led by Bei Bei and Tracey Sletten), with Joshua Wiley as a chief investigator (Wellcome grant summary).
For more info, see the CLASS website.
For questions or other information, email base.class@monash.edu.
Can-Sleep
Can-Sleep is a stepped-care approach to cognitive behavioural therapy for insomnia (CBT-I) for people with cancer who have trouble sleeping. It is a series of projects: the original program for adults after cancer, a version for adolescents and young adults, and two recently completed projects adapting it for people with ovarian cancer and translating it into Vietnamese. Early studies found the program feasible, and insomnia symptoms improved after treatment in adults (Diggens et al., 2025) and in adolescents and young adults (Maccora et al., 2026). Can-Sleep is led by the Psychosocial Oncology Program at the Peter MacCallum Cancer Centre; see Can-Sleep on the Peter Mac website.
REPAT
Approximately one-third of women coping with breast cancer experience persistent symptoms of depression, pain and fatigue, which are not normative and are difficult to treat. Coping by approaching and expressing emotions is linked to fewer depression symptoms and faster recovery. However, expression of emotion is inconsistent with social norms in some cultures. Using visual art-making as a form of expression and communication within a safe and supportive relationship may be an effective way for women from cultures where emotion expression is not normative to approach, process and express their emotions. The Role of Emotional Processing in Art Therapy (REPAT) study was a randomised controlled trial led by the University of Haifa in Israel (study protocol). REPAT evaluated the impact of art-making in women who had completed primary treatment for breast cancer. REPAT also focused on mechanisms, including detailed assessments of emotion regulation and physiological (e.g., cholinergic anti-inflammatory) processes that may underpin the link between art-making and improvements in outcomes. REPAT was also unique in explicitly recruiting both Jewish and Arab women, allowing comparison of cultural differences, including more traditional and collectivist ethno-cultures. In an earlier pilot trial with 20 women, those in art therapy showed greater emotional awareness and acceptance of emotions than those in a mandala-colouring group (Czamanski-Cohen et al., 2019).
STEPS
Adolescents experience naturalistic, recurring sleep restriction during school terms and periods of unrestricted sleep during school holidays. However, relatively little is known about the daily dynamics of sleep and other psychosocial factors, such as affect or cognitive performance, during these periods. The Study of Teenage Emotions, Performance and Sleep (STEPS) aimed to address this gap by measuring daily sleep, performance, and affect across two weeks of school term and two weeks of school holidays in Australian adolescents in Years 11 or 12. Teenagers built up a sleep debt (less sleep than they felt they needed) over school days and reduced it on weekends and holidays, and a larger sleep debt was followed by more negative emotions the next day (Shen et al., 2021). STEPS was led by Dr Lin Shen as part of her PhD.
MYA
The My Year After (MYA) study was a longitudinal cohort study of 460 women recently diagnosed with breast cancer. Women in the study were followed from shortly after breast cancer diagnosis (on average 2.1 months after diagnosis) for 12 months. The study focused on identifying changes in depression symptoms over time and predictors of these different responses. About 38% of women had persistently high depression symptoms over the year (Stanton et al., 2015). Avoiding thoughts and feelings about cancer predicted worse depression outcomes, while accepting and expressing emotions predicted recovery (Stanton et al., 2018). These findings were then used to design a brief intervention to prevent depression in women at risk after a breast cancer diagnosis (Weihs et al., 2019).