Research Article

Cognitive-existential group psychotherapy for women with primary breast cancer: A randomised controlled trial

  1. David W. Kissane1,2,*,
  2. Sidney Bloch1,2,
  3. Graeme C. Smith3,
  4. Patricia Miach3,
  5. David M. Clarke3,
  6. Jillian Ikin1,2,
  7. Anthony Love1,2,
  8. Nadia Ranieri1,2,
  9. Dean McKenzie3

Article first published online: 20 MAY 2003

DOI: 10.1002/pon.683

Issue

Psycho‐Oncology

Psycho-Oncology

Volume 12, Issue 6, pages 532–546, September 2003

Additional Information

How to Cite

Kissane, D. W., Bloch, S., Smith, G. C., Miach, P., Clarke, D. M., Ikin, J., Love, A., Ranieri, N. and McKenzie, D. (2003), Cognitive-existential group psychotherapy for women with primary breast cancer: A randomised controlled trial. Psycho-Oncology, 12: 532–546. doi: 10.1002/pon.683

Author Information

  1. 1

    Department of Psychiatry University of Melbourne, St. Vincent's Hospital and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia

  2. 2

    Department of Medicine, University of Melbourne, St. Vincent's Hospital and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia

  3. 3

    Department of Psychological Medicine, Monash University, Monash Medical Centre, Clayton, Victoria, Australia

*Centre for Palliative Care, St Vincent's Hospital, 41 Victoria Parade, Fitzroy, 3065, Victoria, Australia

Publication History

  1. Issue published online: 12 AUG 2003
  2. Article first published online: 20 MAY 2003
  3. Manuscript Accepted: 3 SEP 2002
  4. Manuscript Revised: 26 AUG 2002
  5. Manuscript Received: 10 MAY 2002

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Abstract

Background. We conducted a randomised, controlled trial of cognitive-existential group therapy (CEGT) for women with early stage breast cancer receiving adjuvant chemotherapy with the aim of improving mood and mental attitude to cancer.

Methods. Women were randomised to 20 sessions of weekly group therapy plus 3 relaxation classes or to a control arm receiving 3 relaxation classes. Assessments, independently done at baseline, 6 and 12 months, included a structured psychiatric interview and validated questionnaires covering mood, attitudes to cancer, family relationships, and satisfaction with therapy.

Results. Three hundred and three of 491 (62%) eligible patients participated over 3 years. Distress was high pre-intervention: 10% were diagnosed as suffering from major depression, 27% from minor depression and 9% from anxiety disorders. On an intention-to-treat analysis, there was a trend for those receiving group therapy (n=154) to have reduced anxiety (p=0.05, 2-sided) compared to controls (n=149). Women in group therapy also showed a trend towards improved family functioning compared to controls (p=0.07, 2-sided). The women in the groups reported greater satisfaction with their therapy (p<0.001, 2-sided), appreciating the support and citing better coping, self-growth and increased knowledge about cancer and its treatment. They valued the CEGT therapy. Overall effect size for the group intervention was small (d=0.25), with cancer recurrence having a deleterious effect in three of the 19 therapy groups. Psychologists as a discipline achieved a moderate mean effect size (d=0.52).

Conclusion. CEGT is a useful adjuvant psychological therapy for women with early stage breast cancer. Interaction effects between group members and therapists are relevant to outcome. Group-as-a-whole effects are powerful, but the training and experience of the therapist is especially critical to an efficacious outcome. Copyright © 2003 John Wiley & Sons, Ltd.

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