Brief cognitive-behavioral and relaxation training interventions for breast cancer: A randomized controlled trial.
OBJECTIVE
Women with breast cancer (BCa) report elevated distress postsurgery. Group-based cognitive-behavioral stress management (CBSM) following surgery improves psychological adaptation, though its key mechanisms remain speculative. This randomized controlled dismantling trial compared 2 interventions featuring elements thought to drive CBSM effects: a 5-week cognitive-behavioral training (CBT) and 5-week relaxation training (RT) versus a 5-week health education (HE) control group.


METHODS
Women with stage 0-III BCa (N = 183) were randomized to CBT, RT, or HE condition 2-10 weeks postsurgery. Psychosocial measures were collected at baseline (T1) and postintervention (T2). Repeated-measures analyses of variance (ANOVAs) tested whether CBT and RT treatments improved primary measures of psychological adaptation and secondary measures of stress management resource perceptions from pre- to postintervention relative to HE.


RESULTS
Both CBT and RT groups reported reduced depressive affect. The CBT group reported improved emotional well-being/quality of life and less cancer-specific thought intrusions. The RT group reported improvements on illness-related social disruption. Regarding stress management resources, the CBT group reported increased reliability of social support networks, while the RT group reported increased confidence in relaxation skills. Psychological adaptation and stress management resource constructs were unchanged in the HE control group.


CONCLUSIONS
Nonmetastatic breast cancer patients participating in 2 forms of brief, 5-week group-based stress management intervention after surgery showed improvements in psychological adaptation and stress management resources compared with an attention-matched control group. Findings provide preliminary support suggesting that using brief group-based stress management interventions may promote adaptation among nonmetastatic breast cancer patients.
Department of Psychology, University of Miami.
Lisa M
LM
Gudenkauf
Department of Psychology, University of Miami.
Michael H
MH
Antoni
Department of Psychology, University of Miami.
Jamie M
JM
Stagl
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine.
Suzanne C
SC
Lechner
Department of Psychology, University of Miami.
Devika R
DR
Jutagir
Department of Psychology, University of Miami.
Laura C
LC
Bouchard
Sylvester Cancer Center, University of Miami Miller School of Medicine.
Bonnie B
BB
Blomberg
Celgene Corporation.
Stefan
S
Glück
Baptist Health Breast Center.
Robert P
RP
Derhagopian
Baptist Health Breast Center.
Gladys L
GL
Giron
Sylvester Cancer Center, University of Miami Miller School of Medicine.
Eli
E
Avisar
Breast Cancer Center of Miami.
Manuel A
MA
Torres-Salichs
Department of Psychology, University of Miami.
Charles S
0000-0002-3688-8545
CS
Carver
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D009367:Neoplasm Staging; D011614:Psychotherapy, Brief / Q000379:methods; D011788:Quality of Life; D012064:Relaxation Therapy; D016037:Single-Blind Method; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000628:therapy*