Neoplasms

Skin and Connective Tissue Diseases

All Conditions

Breast Neoplasms

Breast Diseases

Skin Diseases

Brief supportive-expressive group therapy

David Spiegel, MD

The purpose of this study is to determine whether women with primary breast cancer who were randomly assigned to receive a brief group therapy would show a greater reduction in mood disturbance over time compared to those randomized to the control condition. We also hypothesized that women who were highly distressed at baseline would show the greatest benefit from participating in a support group, and that therapists with more training and experience would be most effective in reducing distress.

Breast cancer patients often experience significant psychological distress after diagnosis and during initial treatment. Group interventions for cancer patients have been shown to improve psychological adjustment. The tests of efficacy for these interventions have typically taken place in university settings using highly developed models of intervention. Our aim was to test our supportive-expressive model in community oncology practices utilizing personnel already working with these populations. To conduct this study of group therapy for primary breast cancer patients, we developed a brief version of the supportive-expressive model (Classen et al., 1993). Our first aim was to test the efficacy of this intervention for reducing mood disturbance for women who received the intervention compared to a control group. A second aim was to examine who was most likely to benefit from the intervention. A third aim was to see if this method could be taught efficiently and effectively to oncology nurses and mental health professionals.

Group Therapy for Primary Breast Cancer

A Multicenter Trial of Group Therapy for Breast Cancer

National Cancer Institute (NCI)

Cummings Foundation

Stanford University

Members assigned to 10-week online support group with a professional counsellor.

online support group

home study support materials

Kate MacGregor, MPH

Joanne Stephen, Ph.D.

Young women who have finished treatment for breast cancer regularly report a lack of psychological and social support in their lives. They often continue to struggle with survivorship issues such as ongoing distress and the challenge of how to rebuild their lives after treatment. This experiment will compare two online support group (OSG) options to determine if both forms of support help young breast cancer survivors adjust, by reducing treatment-related intrusions and helping women re-engage in valued activities and commitments. It will also test if these 2 types of OSG's help womens' mood, feelings of loneliness, confidence, and overall life satisfaction. It will explore the processes within support groups that help to create positive change for young women after cancer treatment.

Previous work by this team in a smaller study has shown that online support groups led by professional counselors can be carried out over the Internet, and that they produce helpful benefits for young women survivors of breast cancer. The online groups were comprised of 10 sessions of real time chats, with each session focused on a specific topic. Participants were provided with an educational manual designed to improve skills for coping after cancer, and they were instructed to read one chapter a week in preparation for the chats. The women enjoyed the groups and 3 months after completing the groups, they reported improved quality of life, lower emotional distress, and enhanced coping. However, a large study to determine the strength and reliability of these early promising findings is needed. The questions to be examined are whether trained peers (other young breast cancer survivors) might be able to facilitate the online groups and provide similar positive benefits for young breast cancer survivors, and what facilitators can do to maximize positive benefits in online support groups.

This is a multi-provincial, 3-arm study that will compare a professionally-led OSG (with an educational manual) and a peer-led OSG (with an education manual) with a group that just receives the educational manual. Psychological assessment measures given immediately following the 12 week group, and at 6 months and 12 months follow-up, will determine if one or both of the study groups effectively improve quality of life, reduce distress, and enhance self-efficacy and life satisfaction for young breast cancer survivors. Additionally, tests will be performed to investigate whether discussing emotional matters predicts greater improvements.

Problem to be investigated: Innovative psychosocial interventions that enhance quality of life as quickly and fully as possible are needed. The psychosocial burden of breast cancer treatments and their sequelae are especially high for younger women (45 years and younger) who are more likely to experience aggressive disease, multi-modal treatments, and higher mortality rates. Psychosocial interventions that can assist women in their return to valued activities and reduce suffering are urgently needed. Illness intrusiveness is a construct and a measure describing the degree to which disease and treatments interfere and disrupt important activities and commitments, and is a key component of quality of life. In previous work, we demonstrated that an internet-delivered psychosocial intervention appeared to reduce illness intrusiveness and distress at follow-up in preliminary pilot data. Professional-led internet-delivered psychosocial interventions are showing promise but there is a need to test efficacy, as well as to develop and test other, less costly interventions that can be utilized by this and other cancer populations. Objectives: To test the efficacy of a 12- week Professional-led Online Support Group plus Education (OSG+E) and a Peer-led OSG+E compared to an Education-alone (E) intervention for reducing illness intrusiveness in young breast cancer survivors, and to test a primary mediator, emotional processing. Secondary objectives are to test additional outcomes, specifically, emotional distress, emotional support, loneliness, self-efficacy and life satisfaction. A third objective is to explore the role of two potential mediators of outcome, emotional suppression and social constraint. Methodology: A 3-arm randomized controlled trial will be employed among Canadian women 45 years of age and younger (N =210 ) who have completed primary treatment for breast cancer. Measures of Illness Intrusiveness, Distress, Life Satisfaction, Self-efficacy, Loneliness and Perceived Support will be collected at baseline, completion of treatment (3 months) and at 6 and 12 months. A form of random regression modeling will be used to create individual slopes to test the primary hypotheses, while multiple regression analyses, based on the MacArthur Model, will test the role of mediators. Significance of the research to breast cancer: Women with breast cancer are using the internet for information gathering and support, and this study will determine the efficacy of two forms of internet-delivered interventions (Professional and Peer) for enhancing the adjustment process after primary treatment is completed. Understanding of mediators will inform understanding of how to enhance efficacy of the 2 models of OSG's. The results will be of value to women with breast cancer as well as health care and community-based supportive care organizations.

A Trial Testing Professional and Peer-led Support Online Support Groups for Young Canadian Breast Cancer Survivors

A Randomized Control Trial Testing the Efficacy of Professional and Peer-Led Online Support Groups for Young Canadian Breast Cancer Survivors

Psychological assessment measures given immediately following the 12 week group, and at 6 months and 12 months follow-up, will determine if one or both of the study groups effectively improve quality of life, reduce distress, and enhance self-efficacy and life satisfaction for young breast cancer survivors. Additionally, tests will be performed to investigate whether discussing emotional matters predicts greater improvements.

University of Calgary

McMaster University

University of British Columbia

Tom Baker Cancer Centre

CancerCare Manitoba

British Columbia Cancer Agency

Pascale MacGregor, Ph.D.

Blood and Lymph Conditions

Immune System Diseases

Rare Diseases

Lymphoma

Lymphoma, Non-Hodgkin

Neoplasms by Histologic Type

Lymphoproliferative Disorders

Lymphatic Diseases

Immunoproliferative Disorders

Lymphosarcoma

Meaning-Centered Group Psychotherapy

Standard Supportive Group Psychotherapy

William Breitbart, MD

Christopher Gibson, PhD

We have developed an 8-week Meaning-Centered Group Psychotherapy designed to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose despite the limitations of their cancer illness. This project's overall aim is to explore the feasibility and efficacy of this new and unique psychotherapy intervention for advanced cancer patients in enhancing psychological and spiritual well-being and quality of life by comparing it with a standard supportive group psychotherapy.

Meaning-Centered Psychotherapy in Advanced Cancer

National Center for Complementary and Integrative Health (NCCIH)

Herbal and Botanical

All Drugs and Chemicals

Tangerine

This is a 1 year pilot study of the feasibility of participation in both in-person and virtual information-based, culturally tailored support groups for Chinese breast cancer patients.

Each support group will consist of 12 sessions. Thirty-two breast cancer patients of Chinese descent will be recruited to participate in the support groups (16 in the inperson groups and 16 in the virtual groups).

in-person support group

virtual support group

Jennifer Leng, MD, MPH

There are few breast cancer support groups that focus on the specific needs of Chinese women. The purpose of this study is to learn about two different ways of providing support groups to help women of Chinese descent cope with the difficulties of a diagnosis of breast cancer and its treatment. The investigators want to learn about how best to support Chinese women with breast cancer by providing two different types of groups: an in-person support group and a virtual (online/phone) support group.

Developing Culturally-Tailored Information-Based Support Groups for Chinese Immigrants With Breast Cancer

Developing Culturally-Tailored Information-Based Support Groups for Chinese Immigrants With Breast Cancer: A Pilot Study

To pilot and evaluate the feasibility of information-based, culturally-tailored in-person and virtual support groups for Chinese patients with breast cancer. The feasibility of participation in the in-person and virtual support groups will be measured by documenting patient accrual to the pilot study and attendance at the support groups.

in the in-person versus virtual support groups on quality of life (QOL), pain, psychosocial outcomes (distress, depression, anxiety, self-efficacy in coping with cancer), and perceived social support. These outcomes will be measured through a baseline and exit Outcomes Survey.

All participants will complete the Brief Support Group Survey at the end of each support meeting to assess satisfaction with and to provide feedback on the usefulness of the meeting and the information presented, ease of understanding and cultural appropriateness of the information, effectiveness of the facilitator, and suggestions for change or improvement.

among support group participants. All patients approached for study participation will complete the Screening Tool, which includes questions related to Internet use. The Screening Tool will be used for all eligible patients (patients refusing to participate will still be asked to complete the screening tool).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Group Therapy for Primary Breast Cancer	NCT00220792	Breast Cancer	Brief supportiv...	0 Years -	Stanford University
A Trial Testing Professional and Peer-led Support Online Support Groups for Young Canadian Breast Cancer Survivors	NCT01089699	Breast Cancer	online support ... online support ... home study supp...	18 Years - 45 Years	British Columbia Cancer Agency
Meaning-Centered Psychotherapy in Advanced Cancer	NCT00067288	Lymphoma, Non-H... Neoplasms	Meaning-Centere... Standard Suppor...	21 Years -	National Center for Complementary and Integrative Health (NCCIH)
Developing Culturally-Tailored Information-Based Support Groups for Chinese Immigrants With Breast Cancer	NCT01632956	Chinese Immigra...	in-person suppo... virtual support...	21 Years - 80 Years	Memorial Sloan Kettering Cancer Center

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