title: Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer.
abstract: OBJECTIVE
  To test the efficacy of meaning-centered group psychotherapy (MCGP) to reduce psychological distress and improve spiritual well-being in patients with advanced or terminal cancer.
  
  
  METHODS
  Patients with advanced cancer (N = 253) were randomly assigned to manualized eight-session interventions of either MCGP or supportive group psychotherapy (SGP). Patients were assessed before and after completing the treatment and 2 months after treatment. The primary outcome measures were spiritual well-being and overall quality of life, with secondary outcome measures assessing depression, hopelessness, desire for hastened death, anxiety, and physical symptom distress.
  
  
  RESULTS
  Hierarchical linear models that included a priori covariates and only participants who attended ≥ three sessions indicated a significant group × time interaction for most outcome variables. Specifically, patients receiving MCGP showed significantly greater improvement in spiritual well-being and quality of life and significantly greater reductions in depression, hopelessness, desire for hastened death, and physical symptom distress compared with those receiving SGP. No group differences were observed for changes in anxiety. Analyses that included all patients, regardless of whether they attended any treatment sessions (ie, intent-to-treat analyses), and no covariates still showed significant treatment effects (ie, greater benefit for patients receiving MCGP v SGP) for quality of life, depression, and hopelessness but not for other outcome variables.
  
  
  CONCLUSIONS
  This large randomized controlled study provides strong support for the efficacy of MCGP as a treatment for psychological and existential or spiritual distress in patients with advanced cancer.
authors: William Breitbart, Hayley Pessin, Allison Applebaum, Julia Kulikowski, and Wendy G. Lichtenthal, Memorial Sloan-Kettering Cancer Center; and Barry Rosenfeld, Fordham University, New York, NY. breitbaw@mskcc.org.
authors: William
authors: W
authors: Breitbart
authors: William Breitbart, Hayley Pessin, Allison Applebaum, Julia Kulikowski, and Wendy G. Lichtenthal, Memorial Sloan-Kettering Cancer Center; and Barry Rosenfeld, Fordham University, New York, NY.
authors: Barry
authors: B
authors: Rosenfeld
authors: William Breitbart, Hayley Pessin, Allison Applebaum, Julia Kulikowski, and Wendy G. Lichtenthal, Memorial Sloan-Kettering Cancer Center; and Barry Rosenfeld, Fordham University, New York, NY.
authors: Hayley
authors: H
authors: Pessin
authors: William Breitbart, Hayley Pessin, Allison Applebaum, Julia Kulikowski, and Wendy G. Lichtenthal, Memorial Sloan-Kettering Cancer Center; and Barry Rosenfeld, Fordham University, New York, NY.
authors: Allison
authors: A
authors: Applebaum
authors: William Breitbart, Hayley Pessin, Allison Applebaum, Julia Kulikowski, and Wendy G. Lichtenthal, Memorial Sloan-Kettering Cancer Center; and Barry Rosenfeld, Fordham University, New York, NY.
authors: Julia
authors: J
authors: Kulikowski
authors: William Breitbart, Hayley Pessin, Allison Applebaum, Julia Kulikowski, and Wendy G. Lichtenthal, Memorial Sloan-Kettering Cancer Center; and Barry Rosenfeld, Fordham University, New York, NY.
authors: Wendy G
authors: WG
authors: Lichtenthal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D003863:Depression / Q000209:etiology / Q000628:therapy*; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D010045:Outpatients; D011615:Psychotherapy, Group; D011788:Quality of Life; D029181:Spirituality; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
references: Med Care. 1988 Jul;26(7):709-23
references: 3393031
references: Cancer. 1986 Jan 1;57(1):183-9
references: 3079660
references: Eur J Cancer. 1994;30A(9):1326-36
references: 7999421
references: Acta Psychiatr Scand. 1983 Jun;67(6):361-70
references: 6880820
references: Psychooncology. 1997 Mar;6(1):65-71
references: 9126716
references: Psychooncology. 1997 Jun;6(2):129-37
references: 9205970
references: Am J Psychiatry. 1999 Jan;156(1):94-100
references: 9892303
references: Psychooncology. 1999 Jan-Feb;8(1):74-91
references: 10202785
references: Psychooncology. 1999 Jul-Aug;8(4):295-305
references: 10474848
references: Arch Gen Psychiatry. 1961 Jun;4:561-71
references: 13688369
references: Soc Sci Med. 2006 Jun;62(12):3133-45
references: 16413644
references: Psychooncology. 2007 Apr;16(4):277-86
references: 17385190
references: J Palliat Med. 2008 Nov;11(9):1234-40
references: 19021487
references: Psychooncology. 2010 Jan;19(1):21-8
references: 19274623
references: Psychol Assess. 2011 Jun;23(2):325-36
references: 21443366
references: Lancet Oncol. 2011 Aug;12(8):753-62
references: 21741309
references: J Clin Oncol. 2012 Apr 20;30(12):1304-9
references: 22370330
references: J Consult Clin Psychol. 2014 Oct;82(5):906-19
references: 24708350
references: Palliat Med. 1995 Jul;9(3):207-19
references: 7582177
references: Psychooncology. 1999 Sep-Oct;8(5):417-28
references: 10559801
references: Am J Psychother. 2000 Fall;54(4):486-500
references: 11109133
references: Arch Gen Psychiatry. 2001 May;58(5):494-501
references: 11343530
references: Support Care Cancer. 2002 May;10(4):272-80
references: 12029426
references: Oncol Nurs Forum. 2003 Mar-Apr;30(2):291-300
references: 12692663
references: Psychooncology. 2003 Sep;12(6):532-46
references: 12923794
references: J Psychiatr Res. 1975 Nov;12(3):189-98
references: 1202204
references: Am J Psychiatry. 1977 Apr;134(4):396-400
references: 842726
references: Arch Gen Psychiatry. 1981 May;38(5):527-33
references: 7235853