Group psychotherapy for recently diagnosed breast cancer patients: A multicenter feasibility study

As many as 80% of breast cancer patients report significant distress during initial treatment, yet there is little in the way of systematic psychother apeutic interventions for women coping with the stress of a recent diagnosi s of breast cancer. The literature on psychotherapeutic treatment of cancer patients provides uniform evidence for an improvement in mood, coping and adjustment as a result of group therapy. The present study examined the fea sibility of implementing a manualized treatment, supportive-expressive grou p psychotherapy, in busy oncology practices across the US. This interventio n was applied to women with primary breast cancer in a manner which tests n ot only the efficacy of the approach but also its accessibility to group th erapists not previously experienced in its use. One hundred and eleven brea st cancer patients within 1 year of diagnosis were recruited from ten geogr aphically diverse sites of the National Cancer Institute's Community Clinic al Oncology Program (CCOP) and two academic medical centers. Two therapists from each site were trained in supportive-expressive group psychotherapy. Training consisted of participation in a workshop, reading a treatment manu al, and viewing explanatory videotapes. Each patient participated in a supp ortive-expressive group that met for 12 weekly sessions lasting 90 min. Ass essment of mood disturbance was made at entry, 3, 6, and 12 months. Results indicated a significant 40% decrease in the Total Mood Disturbance (TMD) s cores of the Profile of Mood States (POMS) (ANOVA F [2,174] = 3.98, p < 0.0 5). The total symptom score of the Hospital Anxiety and Depression Scale (H ADS) was likewise significantly reduced over the 6-month period (F [2,174] = 5.2, p < 0.01). Similarly, the total score of the Impact of Event Scale ( TES) was significantly reduced (F [2,174] = 4.0, p < 0.05). There was subst antial uniformity of treatment effect across sites. Outcome was independent of stage of disease (I us. II). We conclude that this treatment program ca n be effectively implemented in a community setting and results in reduced distress among breast cancer patients. Copyright (C) 1999 John Wiley & Sons , Ltd.