Effect of Group Therapy for Breast Cancer on Healthcare Utilization


  • J. Steven A. Simpson ph d, md,

    1. J. Steven A. Simpson, PhD, MD, Assistant Professor, Department of Psychiatry; Adjunct Assistant Professor, Department of Oncology, University of Calgary; Consulting Psychiatrist, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
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  • Linda E. Carlson ph d,

    1. Linda E. Carlson, PhD, Clinical Psychologist, Postdoctoral Fellow, Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Alberta, Canada.
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  • Michael E. Trew md

    1. Michael E. Trew, MD, Clinical Associate Professor, Department of Psychiatry, University of Calgary, Alberta, Canada.
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  • This research was funded by the Health Services Research and Innovation Fund of the Alberta Heritage Foundation for Medical Research. Dr. Linda Carlson is a Terry Fox Postdoctoral Research Fellow funded by the National Cancer Institute of the Canadian Cancer Society.

Address for correspondence: Steve Simpson, PhD, MD, Department of Psychiatry, Foothills Hospital, 1403 29 Street NW, Calgary, Alberta, Canada T2N 2T9; e-mail: steve.simpson@crha-health.ab.ca.


Purpose: The purpose of this study was to determine whether participation in a group psychosocial intervention by patients with breast cancer would result in an improvement in psychological measures and in reduced billings in general medical expenses.

description of Study: Eligible women who had completed treatment for stage 0, I, or II primary breast cancer were prospectively and randomly assigned to either the intervention (n = 46) or control (n = 43) group. Both groups received the usual psychosocial care; however, the intervention group also participated in six weekly cognitive/behavioral psychosocial meetings. All were assessed on psychiatric symptoms, mood, depression, and coping strategies at four time periods: preintervention, postintervention, 1-year follow-up, and 2-year follow-up. Alberta Healthcare billing records were obtained covering the 2-year follow-up period to determine the amount billed per person over the course of the study.

Results: Women in the intervention group had less depression, less overall mood disturbance, better overall quality of life, and fewer psychiatric symptoms than those in the control group, beginning immediately postintervention and remaining so at 2 years postintervention. Billing in the intervention group was an average of $147 less than in the control group, a 23.5% reduction.

clinical Implications: This is the first study to show that a psychosocial intervention can reduce direct healthcare billings in a sample of patients with cancer. Importantly, these findings help to justify the routine availability of such programs in cancer treatment facilities worldwide.