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Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial

Published online by Cambridge University Press:  04 April 2017

N. van der Spek ,
J. Vos ,
C. F. van Uden-Kraan ,
W. Breitbart ,
P. Cuijpers ,
K. Holtmaat ,
B. I. Witte ,
R. A. E. M. Tollenaar  and
I. M. Verdonck-de Leeuw
N. van der Spek
Affiliation:
Department of Clinical Psychology, VU University, Amsterdam, the Netherlands IDC Center for Psychological Care for Cancer Patients, OLVG Hospital, Amsterdam, the Netherlands
J. Vos
Affiliation:
Department of Psychology, University of Roehampton, London, UK
C. F. van Uden-Kraan
Affiliation:
Department of Clinical Psychology, VU University, Amsterdam, the Netherlands
W. Breitbart
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
P. Cuijpers
Affiliation:
Department of Clinical Psychology, VU University, Amsterdam, the Netherlands
K. Holtmaat
Affiliation:
Department of Clinical Psychology, VU University, Amsterdam, the Netherlands
B. I. Witte
Affiliation:
Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
R. A. E. M. Tollenaar
Affiliation:
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
I. M. Verdonck-de Leeuw*
Affiliation:
Department of Clinical Psychology, VU University, Amsterdam, the Netherlands VU University Medical Center, Department of Otolaryngology – Head & Neck Surgery, Amsterdam, the Netherlands
*
*Address for correspondence: I. M. Verdonck-de Leeuw, Department of Clinical Psychology, VU University, Amsterdam, the NetherlandsBoechorststraat 1, room 2E-21, 1081 BT, Amsterdam, the Netherlands. (Email: im.verdonck@vu.nl)
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Abstract

Background

The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU).

Method

A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU).

Results

Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = −0.87) (3 months FU); and distress (d = −0.6) and depression (d = −0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU).

Conclusions

MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.

Keywords

Group psychotherapycancer survivorsmeaningRCTpsychological well-being
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 11 , August 2017 , pp. 1990 - 2001
Copyright
Copyright © Cambridge University Press 2017 

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