Breitbart W, Rosenfeld B, Pessin H, Applebaum A, Kulikowski J, Lichtenthal WG. (2015). Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology, 33 (7), 749-754.
Meaning-Centered Group Psychotherapy for Patients with Advanced Cancer
|Program Title||Meaning-Centered Group Psychotherapy for Patients with Advanced Cancer|
|Purpose||Designed to enhance the quality of life for cancer survivors. (2015)|
|Program Focus||Psychosocial - Anxiety, Psychosocial - Coping, Psychosocial - Depression and Psychosocial - Stress/distress (post-traumatic stress)|
|Population Focus||Cancer Survivors|
|Age||Adults (40-65 years), Older Adults (65+ years), Young Adults (19-39 years)|
|Race/Ethnicity||Asian, Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin|
|Funded by||NCI (Grant number(s): CA 128187)|
|User Reviews||(Be the first to write a review for this program)|
The manualized intervention is delivered to a group of 810 participants by 2 clinicians. The themes covered in the sessions include concepts and sources of meaning; cancer meaning; sources of meaning focused on the past; sources of meaning focused on the present and future; encountering lifes limitations; creativity and responsibility; experiential sources of meaning in nature, art, and humor; and intervention termination (goodbyes and hopes for the future). Each of eight weekly 90-minute sessions includes a participant check-in, an introduction to the session topic, an exercise that engages patients in active group discussions, and a wrap-up exercise reflecting on the session theme. Participants are given homework assignments in preparation for subsequent sessions.
Clinicians must be masters-level psychologists or social workers with a background in psycho-oncology and participate in the training workshops from the MCGP team at the Memorial Sloan-Kettering Cancer Center. Each trainee conducts a session while a trainer completes a treatment adherence form to measure the clinicians ability to facilitate the intervention with fidelity.
-- 34 hours for clinician training, which includes reviewing the treatment manual, listening to cases, and role-playing cases
-- 90 minutes for the trainee to conduct a session and the trainer to complete the treatment adherence coding sheet
-- 60 minutes for weekly ongoing supervision
-- Meaning-Centered Group Psychotherapy (MCGP) for Patients With Advanced Cancer Treatment Manual
-- MCGP Independent Rater-Treatment Integrity Coding Form
-- Treatment Adherence Coding Manual for MCGP
For costs associated with this program, please contact the developer, William Breitbart. (See products page on the RTIPs website for developer contact information.)
Patients were randomized to MCGP or to Supportive Group Psychotherapy (SGP). Like MCGP, SGP is a manualized intervention delivered in eight weekly sessions to patients with advanced cancer. It helps patients cope by encouraging them to share concerns related to their diagnosis and treatment, describe experiences and emotions related to cancer, identify challenges they face, and offer support and advice to one another. Clustered randomization was used to assign 253 patients to either MCGP (n=132) or SGP (n=121). Groups of 810 participants were formed and then randomly assigned to either MCGP or SGP, with each set of 8 groups containing 4 MCGP and 4 SGP groups.
MCGP sessions were led by a psychiatrist, clinical psychologist, or social worker with experience treating patients with advanced cancer and co-facilitated by either a second clinician or clinical psychology doctoral student. SGP sessions were facilitated by a clinical psychologist or social worker along with a co-therapist. Clinicians leading both MCGP and SGP groups were trained in the respective approaches and received weekly supervision. In addition, sessions were audio-recorded and coded by two independent reviewers to measure adherence to the manualized format.
Females represented 69.6% of study participants, and males represented 30.4%. The sample ranged in age from 27 to 91 years with a mean age of 58.2 years. The sample was White (69.0%), African American (13.9%), Hispanic (10.3%), and other (6.7%).
The primary outcomes were spiritual well-being and quality of life, and the secondary outcomes were depression, desire for hastened death, hopelessness, physical symptoms of distress, and anxiety. Participants completed self-report questionnaires to measure primary and secondary outcomes before participating in the group intervention, after the last group session, and 2 months after completion of treatment. Outcomes were measured using the following instruments:
-- Spiritual well-being: Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale
-- Quality of life: McGill Quality of Life Questionnaire
-- Depression: Beck Depression Inventory
-- Desire for hastened death: Schedule of Attitudes Toward Hastened Death
-- Hopelessness: Hopelessness Assessment in Illness Questionnaire
-- Physical symptoms of distress: Memorial Symptom Assessment Scale Global Distress Index
-- Anxiety: Anxiety subscale of the Hospital Anxiety and Depression Scale
Treatment effects were evaluated across all three time points for participants who attended at least three group sessions (either MCGP or SGP).
- Among study participants attending three or more sessions, those receiving MCGP showed significantly greater increases in spiritual well-being compared with those receiving SGP (p<.05)
- Among study participants attending three or more sessions, those receiving MCGP showed significantly greater increases in quality of life compared with those receiving SGP (p<.05)
- Among study participants attending three or more sessions, those receiving MCGP showed significantly greater decreases in depression compared with those receiving SGP (p<.05).
- Among study participants attending three or more sessions, those receiving MCGP showed significant decreases in desire for hastened death compared with those receiving SGP (p<.05).
- Among study participants attending three or more sessions, those receiving MCGP showed significant decreases in hopelessness compared with those receiving SGP (p<.05).
- Among study participants attending three or more sessions, those receiving MCGP showed significantly greater decreases in physical symptoms of distress compared with those receiving SGP (p<.05).
Breitbart, W, Applebaum, A. (2011). Meaning-Centered Group Psychotherapy. In Watson M, Kissane, DW (Eds.), Handbook of Psychotherapy, 137-148. West Sussex, United Kingdom: John Wiley & Sons, Ltd, .
Breitbart W, Rosenfeld B, Gibson C, Pessin H, Poppito S, Nelson C, Tomarken A, Timm AK, Berg A, Jacobson C, Sorger B, Abbey J, Olden M. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-oncology, 19 , 21-28.
(Be the first to write a review for this program)