title: Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial.
abstract: BACKGROUND
  The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU).
  
  
  METHODS
  A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU).
  
  
  RESULTS
  Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = -0.87) (3 months FU); and distress (d = -0.6) and depression (d = -0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU).
  
  
  CONCLUSIONS
  MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.
authors.affiliation: Department of Clinical Psychology,VU University,Amsterdam,the Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: van der Spek
authors.affiliation: Department of Psychology,University of Roehampton,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Vos
authors.affiliation: Department of Clinical Psychology,VU University,Amsterdam,the Netherlands.
authors.forename: C F
authors.initials: CF
authors.lastname: van Uden-Kraan
authors.affiliation: Department of Psychiatry and Behavioral Sciences,Memorial Sloan-Kettering Cancer Center,New York, NY,USA.
authors.forename: W
authors.initials: W
authors.lastname: Breitbart
authors.affiliation: Department of Clinical Psychology,VU University,Amsterdam,the Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Department of Clinical Psychology,VU University,Amsterdam,the Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Holtmaat
authors.affiliation: Epidemiology & Biostatistics,VU University Medical Center,Amsterdam,the Netherlands.
authors.forename: B I
authors.initials: BI
authors.lastname: Witte
authors.affiliation: Department of Surgery,Leiden University Medical Center,Leiden,The Netherlands.
authors.forename: R A E M
authors.initials: RAEM
authors.lastname: Tollenaar
authors.affiliation: Department of Clinical Psychology,VU University,Amsterdam,the Netherlands.
authors.forename: I M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D000073116:Cancer Survivors / Q000523:psychology*; D003863:Depression / Q000523:psychology* / Q000628:therapy; D005260:Female; D065026:Hope; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067656:Optimism / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction; D011615:Psychotherapy, Group / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*
keywords: Group psychotherapy; RCT; cancer survivors; meaning; psychological well-being