Family-focused Therapy Improves Grieving and Coping in Families at High Risk for Dysfunction

Severity of complicated grief and risk of prolonged grief disorder are reduced in high-risk families that receive family-focused therapy during palliative care and into bereavement, according to a study published in the Journal of Clinical Oncology.1

Certain levels of dysfunction indicate a family may need systematic family-centered cancer care when advanced cancer is diagnosed in a relative. In this randomized controlled trial, researchers assessed the effectiveness of standard care vs manualized family intervention in families at risk from dysfunctional relationships due to an advanced cancer diagnosis in a relative.

Continue Reading Below

After screening 1488 patients or relatives at Memorial Sloan Kettering Cancer Center or 3 related community hospice programs, 620 patients (42%), representing 170 families, were recruited for this study. The families were stratified by 3 levels of family dysfunction (low communicating, low involvement, and high conflict) and randomly assigned to 1 of 3 arms: standard care, 6 sessions of a manualized family intervention, or 10 sessions of the intervention. Primary outcomes were measured with the Complicated Grief Inventory-Abbreviated (CGI) and Beck Depression Inventory-II (BDI-II). Generalized estimating equations allowed for clustered data in an intention-to-treat analysis.

The CGI revealed a significant treatment effect (Wald χ2 = 6.88; df = 2; P = .032) and treatment by family-type interaction (Wald χ2 = 20.64; df = 4; P < .001). Ten sessions of the intervention resulted in better outcomes than did standard care for low-communicating and high-conflict families compared with low-involvement families.

Low-communicating families improved by 6 months of bereavement. At 13 months of bereavement, 15.5% of the bereaved in the standard care arm developed a prolonged grief disorder compared with 3.3% of those who received 10 sessions of the intervention (Wald χ2 = 8.31; df = 2; P =.048). No significant treatment effects were found on the BDI-II.

REFERENCE

1. Kissane DW, Zaider TI, Li Y, et al. Randomized Controlled Trial of Family Therapy in Advanced Cancer Continued Into Bereavement [published online ahead of print April 11, 2016]. J Clin Oncol. doi:10.1200/JCO.2015.63.0582.

Loading links....
You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs