Individual Meaning-Centered Psychotherapy May Improve Distress in Advanced Cancer

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The number of psychotherapeutic interventions with an emphasis on spirituality is growing in number.
The number of psychotherapeutic interventions with an emphasis on spirituality is growing in number.

Individual meaning-centered psychotherapy (IMCP) significantly improves psychological outcomes and spiritual well-being among patients with advanced cancer compared with enhanced usual care (EUC) or supportive psychotherapy (SP), according to a study published in Cancer.

Many patients with advanced cancer experience spiritual and existential distress, and the number of psychotherapeutic interventions with an emphasis on spirituality is growing. Previous studies evaluating these interventions, however, have led to mixed results, and were never completed in large, systematic clinical trials.

For this study, researchers randomly assigned 321 patients to the IMCP, SP, or EUC treatment groups between March 2011 and March 2016. Eligible patients had stage IV solid tumor cancer and were experiencing at least moderate distress. Patients were evaluated at baseline (prior to intervention), 4 weeks (mid-intervention), 8 weeks after treatment, and 16 weeks after treatment. No significant demographic differences were noted among study participants.

Patients in the IMCP arm had small-to-moderate but significant treatment effects for 5 of the 7 outcome variables assessed compared to patients receiving EUC (no-treatment comparison): quality of life, spiritual well-being, sense of meaning, desire for hastened death, and anxiety.

IMCP significantly improved quality of life and sense of meaning measures only when compared to SP. There were no significant improvements reported among patients who received SP. 

Results show that IMCP effectively improves quality of life and spiritual well-being among patients with advanced cancer, and reduces psychological distress. The authors concluded that “moreover, although this intervention was designed for patients with advanced cancer, the focus on (and utility for) enhancing meaning and quality of life may have broad applicability across a range of illnesses and conditions in which physical and psychological functioning is adversely affected.” 

Reference

Breitbart W, Pessin H, Rosenfeld B, et al. Individual meaning‐centered psychotherapy for the treatment of psychological and existential distress: a randomized controlled trial in patients with advanced cancer [published online May 14, 2018]. Cancer. doi: 10.1002.cncr.31539
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