title: Managing Cancer And Living Meaningfully (CALM): phase 2 trial of a brief individual psychotherapy for patients with advanced cancer.
abstract: BACKGROUND
  Advanced cancer brings substantial physical and psychosocial challenges that may contribute to emotional distress and diminish well-being. In this study, we present preliminary data concerning the effectiveness of a new brief individual psychotherapy, Managing Cancer And Living Meaningfully (CALM), designed to help individuals cope with this circumstance.
  
  
  OBJECTIVE
  To test the feasibility and preliminary effectiveness of CALM to reduce emotional distress and promote psychological well-being and growth.
  
  
  METHODS
  CALM is a brief, manualized, semi-structured individual psychotherapy for patients with advanced cancer. This study employed a phase 2 intervention-only design. The primary outcome was depressive symptoms and the secondary outcomes were death anxiety, attachment security, spiritual well-being and psychological growth. These were assessed at 3 months (t1) and 6 months (t2). Multilevel regression was used to model change over time.
  
  
  METHODS
  A total of 50 patients with advanced or metastatic cancer were recruited from the Princess Margaret Cancer Centre, Toronto, Canada.
  
  
  RESULTS
  A total of 39 patients (78%) were assessed at baseline, 24 (48%) at t1, and 16 (32%) at t2. Analyses revealed reductions over time in depressive symptoms: beta = -0.13, confidence interval (CI.95) = (-0.23, -0.022) and death anxiety: beta = -0.23, CI.95 (-0.40, -0.061); and an increase in spiritual well-being: beta = 0.14, CI.95 (0.026, 0.26).
  
  
  CONCLUSIONS
  CALM may be a feasible intervention to benefit patients with advanced cancer. The results are encouraging, despite attrition and small effect sizes, and support further study.
authors.affiliation: 1Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Lo
authors.forename: Sarah
authors.initials: S
authors.lastname: Hales
authors.forename: Judy
authors.initials: J
authors.lastname: Jung
authors.forename: Aubrey
authors.initials: A
authors.lastname: Chiu
authors.forename: Tania
authors.initials: T
authors.lastname: Panday
authors.forename: Anne
authors.initials: A
authors.lastname: Rydall
authors.forename: Rinat
authors.initials: R
authors.lastname: Nissim
authors.forename: Carmine
authors.initials: C
authors.lastname: Malfitano
authors.forename: Danielle
authors.initials: D
authors.lastname: Petricone-Westwood
authors.forename: Camilla
authors.initials: C
authors.lastname: Zimmermann
authors.forename: Gary
authors.initials: G
authors.lastname: Rodin
mesh_terms: D001293:Attitude to Death; D003866:Depressive Disorder / Q000209:etiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000379:methods; D010865:Pilot Projects; D011614:Psychotherapy, Brief / Q000592:standards*; D036301:Qualitative Research; D012044:Regression Analysis; D013315:Stress, Psychological / Q000517:prevention & control
keywords: Affective symptoms; cancer; death anxiety; depression; palliative care; pilot trial; psychotherapy