title: Therapy processes, progress, and outcomes for 2 therapies for gynecological cancer patients.
abstract: OBJECTIVE
  Although a number of effective psychotherapies have been identified for cancer patients, little is known about therapy processes, as they unfold the course of treatment and the role of therapy processes in treatment outcome. We used growth curve modeling to evaluate the associations between therapy processes and outcomes among gynecological cancer patients participating in 2 types of therapy.
  
  
  METHODS
  Two hundred twenty five women newly diagnosed with gynecological cancer were randomly assigned to receive 8 sessions of a coping and communication intervention or a client-centered supportive therapy. Participants completed measures of preintervention and postintervention depression, working alliance after Session 2, and postsession progress and depressive symptoms after each session. Therapists completed measures of perceived patient progress.
  
  
  RESULTS
  Both patients and therapists reported a steady increase in session progress and patients reported a steady decrease in depressive symptoms over the course of both the coping and communication intervention and client-centered supportive sessions. Perceived progress in one session predicted progress in the subsequent session. Early working alliance predicted improved session progress and reductions in postsession depressive symptoms over sessions. Working alliance did not predict prepost treatment changes in depression. Patient-rated session progress predicted greater reductions in pretreatment to posttreatment depression, but therapist-rated progress did not.
  
  
  CONCLUSIONS
  For 2 types of treatment delivered to women diagnosed with gynecological cancer, patient-rated session progress and depressive symptoms rated over therapy sessions may serve as a yardstick that can be useful to therapists to gauge patient's response to treatment.
authors.affiliation: Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Manne
authors.affiliation: Temple University School of Dentistry, Philadelphia, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Myers-Virtue
authors.affiliation: Michigan State University, Michigan, USA.
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Kashy
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Ozga
authors.affiliation: Monash University, Melbourne, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Kissane
authors.affiliation: Fox Chase Cancer Center, Philadelphia, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Heckman
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Morgan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy; D003866:Depressive Disorder; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010465:Perception; D011369:Professional-Patient Relations; D011613:Psychotherapy; D016896:Treatment Outcome
keywords: cancer; cognitive therapy; generic model of psychotherapy; session progress; supportive therapy; therapeutic process; working alliance