title: In Psycho-Spiritual Integrative Therapy for Women with Primary Breast Cancer, What Factors Account for the Benefits? Insights from a Multiple Case Analysis.
abstract: This study sought to understand the context in which Psycho-Spiritual Integrative Therapy (PSIT), a group intervention, promotes varying degrees of spiritual growth and quality of life change in breast cancer survivors. A secondary aim was to explore the relationship between spiritual well-being (SWB) and Quality of Life (QL) in PSIT participants. A qualitative, multiple case analysis was undertaken to examine the experiences of two participants with the highest change scores on the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale-Expanded Version (FACIT-Sp-Ex) and two participants with among the lowest change scores on this measure. The participant factors thought to contribute to SWB and QL changes included utilization of metacognitive psychological skills and spiritual/religious frameworks, while PSIT factors included application of PSIT core intervention components, cognitive restructuring, group dynamics, and the role of the facilitator. The nature and extent of participant use of spiritual practices appeared to shape the relationship between SWB and OL. The findings suggest directions for future research to investigate potential moderators and mediators of treatment efficacy of PSIT specifically, as well as other psycho-spiritual interventions for cancer survivors more generally.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA. jrettger@stanford.edu.
authors.forename: John
authors.initials: J
authors.lastname: Rettger
authors.affiliation: Sofia University, 1069 E Meadow Circle, Palo Alto, CA 94303, USA. kewall@sbcglobal.net.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Wall
authors.affiliation: Independent Practice, 1069 E Meadow Circle, Palo Alto, CA 94303, USA. dcorwin@paloaltou.edu.
authors.forename: Diana
authors.initials: D
authors.lastname: Corwin
authors.affiliation: Kaiser Permanente, 820 Las Gallinas Avenue, San Rafael, CA 94903, USA. alexandra.n.davidson@kp.org.
authors.forename: Alexandra N
authors.initials: AN
authors.lastname: Davidson
authors.affiliation: Sofia University, 1069 E Meadow Circle, Palo Alto, CA 94303, USA. david.lukoff@sofia.edu.
authors.forename: David
authors.initials: D
authors.lastname: Lukoff
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA. koopman@stanford.edu.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Koopman
keywords: breast cancer; group intervention; integrative cancer care; mindfulness; quality of life; spiritual well-being; spirituality