Supportive-expressive group therapy and distress in patients with metastatic breast cancer - A randomized clinical intervention trial

Background: Metastatic breast cancer carries with it considerable psychosoc ial morbidity. Studies have shown that some patients with metastatic breast cancer experience clinically significant anxiety and depression and trauma tic stress symptoms. Supportive-expressive group psychotherapy was develope d to help patients with cancer face and adjust to their existential concern s, express and manage disease-related emotions, increase social support, en hance relationships with family and physicians, and improve symptom control . Methods: Of 125 women with metastatic breast cancer recruited into the stud y, 64 were randomized to the intervention and 61 to the control condition. Intervention women were offered 1 year of weekly supportive-expressive grou p therapy and educational materials. Control women received educational mat erials only. Participants were assessed at baseline and every 4 months duri ng the first year. Data at baseline and from at least 1 assessment were col lected from 102 participants during this 12-month period, and these partici pants compose the study population. Results: Primary analyses based on all available data indicated that partic ipants in the treatment condition showed a significantly greater decline in traumatic stress symptoms on the Impact of Event Scale (effect size, 0.25) compared with the control condition,but there was no difference in Profile of Mood States total mood disturbance. However, when the final assessment occurring within a year of death was removed, a secondary analysis showed a significantly greater decline in total mood disturbance (effect sire, 0.25 ) and traumatic stress symptoms (effect size, 0.33) for the treatment condi tion compared with the control condition. Conclusion: Supportive-expressive therapy, with its emphasis on providing s upport and helping patients face and deal with their disease-related stress , can help reduce distress in patients with metastatic breast cancer.