Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial.
OBJECTIVE
An increasingly important concern for clinicians who care for patients at the end of life is their spiritual well-being and sense of meaning and purpose in life. In response to the need for short-term interventions to address spiritual well-being, we developed Meaning Centered Group Psychotherapy (MCGP) to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose in their lives, even as they approach the end of life.


METHODS
Patients with advanced (stage III or IV) solid tumor cancers (N=90) were randomly assigned to either MCGP or a supportive group psychotherapy (SGP). Patients were assessed before and after completing the 8-week intervention, and again 2 months after completion. Outcome assessment included measures of spiritual well-being, meaning, hopelessness, desire for death, optimism/pessimism, anxiety, depression and overall quality of life.


RESULTS
MCGP resulted in significantly greater improvements in spiritual well-being and a sense of meaning. Treatment gains were even more substantial (based on effect size estimates) at the second follow-up assessment. Improvements in anxiety and desire for death were also significant (and increased over time). There was no significant improvement on any of these variables for patients participating in SGP.


CONCLUSIONS
MCGP appears to be a potentially beneficial intervention for patients' emotional and spiritual suffering at the end of life. Further research, with larger samples, is clearly needed to better understand the potential benefits of this novel intervention.
Breitbart
William
W
Department of Psychiatryand Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. breitbaw@mskcc.org
Rosenfeld
Barry
B
Gibson
Christopher
C
Pessin
Hayley
H
Poppito
Shannon
S
Nelson
Christian
C
Tomarken
Alexis
A
Timm
Anne Kosinski
AK
Berg
Amy
A
Jacobson
Colleen
C
Sorger
Brooke
B
Abbey
Jennifer
J
Olden
Megan
M
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D004644:Emotions; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D009519:New York City; D010166:Palliative Care / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology; D017060:Patient Satisfaction; D010865:Pilot Projects; D011615:Psychotherapy, Group; D012657:Self-Help Groups; D029181:Spirituality; D013727:Terminal Care / Q000523:psychology; D055815:Young Adult