title: Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer.
abstract: OBJECTIVE
  Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer.
  
  
  METHODS
  Patients with stage III or IV cancer (N = 120) were randomly assigned to seven sessions of either IMCP or therapeutic massage (TM). Patients were assessed before and after completing the intervention and 2 months postintervention. Primary outcome measures assessed spiritual well-being and quality of life; secondary outcomes included anxiety, depression, hopelessness, symptom burden, and symptom-related distress.
  
  
  RESULTS
  Of the 120 participants randomly assigned, 78 (65%) completed the post-treatment assessment and 67 (56%) completed the 2-month follow-up. At the post-treatment assessment, IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being (b = 0.39; P <.001, including both components of spiritual well-being (sense of meaning: b = 0.34; P = .003 and faith: b = 0.42; P = .03), and quality of life (b = 0.76; P = .013). Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden (b = -6.56; P < .001) and symptom-related distress (b = -0.47; P < .001) but not for anxiety, depression, or hopelessness. At the 2-month follow-up assessment, the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group.
  
  
  CONCLUSIONS
  IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY 10022, USA. breitbaw@mskcc.org
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
authors.forename: Shannon
authors.initials: S
authors.lastname: Poppito
authors.forename: Barry
authors.initials: B
authors.lastname: Rosenfeld
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Vickers
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Li
authors.forename: Jennifer
authors.initials: J
authors.lastname: Abbey
authors.forename: Megan
authors.initials: M
authors.lastname: Olden
authors.forename: Hayley
authors.initials: H
authors.lastname: Pessin
authors.forename: Wendy
authors.initials: W
authors.lastname: Lichtenthal
authors.forename: Daniel
authors.initials: D
authors.lastname: Sjoberg
authors.forename: Barrie R
authors.initials: BR
authors.lastname: Cassileth
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D010349:Patient Compliance / Q000706:statistics & numerical data; D010865:Pilot Projects; D057285:Precision Medicine / Q000379:methods*; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods; D011788:Quality of Life; D029181:Spirituality; D013727:Terminal Care / Q000379:methods; D019452:Terminally Ill / Q000523:psychology*; D016896:Treatment Outcome