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Cognitive Behaviour Therapy for Menopausal Hot Flushes and Night Sweats: A Qualitative Analysis of Women's Experiences of Group and Self-Help CBT

Published online by Cambridge University Press:  04 September 2012

Janet Balabanovic
Affiliation:
Institute of Psychiatry, Kings College London, UK
Beverley Ayers
Affiliation:
Institute of Psychiatry, Kings College London, UK
Myra S. Hunter*
Affiliation:
Institute of Psychiatry, Kings College London, UK
*
Reprint requests to Myra S. Hunter, Professor of Clinical Health Psychology, Institute of Psychiatry, King's College London, 5th Floor Bermondsey Wing, Guys Campus, London SE1 9RT, UK. E-mail: [email protected]

Abstract

Background: There is a growing need for non-medical treatments for women experiencing problematic menopausal symptoms such as hot flushes and night sweats (HF/NS). A recent randomized control trial (RCT) (MENOS2) provides evidence of the effectiveness of Group CBT and Self-Help CBT for HF/NS. Aims: This study examines MENOS 2 participants’ experience of the CBT treatments. Method: Twenty women who had experienced CBT for HF/NS (10 Group CBT and 10 Self-Help CBT) were interviewed at the end of the trial to explore how they experienced the treatment and its effects. The interviews were analysed using interpretative phenomenological analysis. Results: Women experienced both treatment formats as positive and helpful, increasing their ability to cope and their sense of control over HF/NS. Four super-ordinate themes were identified: making sense of symptom change, new ways of coping and regaining control, acknowledging and challenging the menopause taboo, and social interaction and support versus individual learning. Conclusions: These qualitative results are consistent with those of the main trial in that women found both CBT formats helpful in reducing the impact of HF/NS. However, the results also suggest possible mechanisms of change and provide useful information on women's responses to the different treatment components and formats.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012 

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References

Ayers, B., Mann, E. and Hunter, M. S. (2011). A randomized controlled trial of cognitive behaviour therapy for women with problematic menopausal hot flushes: MENOS 2 Trial protocol. British Medical Journal Open. doi:10.1136/bmjopen-2010-000047CrossRefGoogle Scholar
Ayers, B., Smith, M., Hellier, J., Mann, E. and Hunter, M. S. (2012). Effectiveness of group and self-help cognitive behaviour therapy to reduce problematic menopausal hot flushes and night sweats (MENOS 2): a randomised controlled trial. Menopause: Journal of the North American Menopause Society, 19, 749759.CrossRefGoogle Scholar
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77101. doi: 10.1191/1478088706qp063oaCrossRefGoogle Scholar
Carpenter, J. and Rand, K. (2008). Modelling the hot flash experience in breast cancer survivors. Menopause, 15, 469475.CrossRefGoogle ScholarPubMed
Freedman, R. and Woodward, S. (1992). Behavioral treatment of menopausal hot flushes: evaluation by ambulatory monitoring. American Journal of Obstetrics and Gynecology, 167, 436439.CrossRefGoogle ScholarPubMed
Gabriel, S., Hsia, J., Johnson, K. J. R., Sanchez, G. and Bonfill, X. (2002). Hormone replacement therapy for preventing cardiovascular disease in postmenopausal women. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD002229CrossRefGoogle Scholar
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioural and cognitive therapies. Behaviour Therapy, 35, 639665.CrossRefGoogle Scholar
Hayes, S. C., Follette, V. M. and Lineham, M. M. (2004). Mindfulness and Acceptance: expanding the cognitive behavioural tradition. New York: Guilford.Google Scholar
Hunter, M. S., Ayers, B. and Smith, M. (2011). The Hot Flush Behaviour Scale: a measure of behavioural reactions to menopausal hot flushes and night sweats. Menopause: The Journal of the North American Menopause Society, 18, 11781183.CrossRefGoogle Scholar
Hunter, M. S., Coventry, S., Hamed, H., Fentiman, I. and Grunfeld, E. A. (2009). Evaluation of a group cognitive behavioural intervention for women suffering from menopausal symptoms following breast cancer treatment. Psycho Oncology, 18, 560563.CrossRefGoogle ScholarPubMed
Hunter, M. S., Gentry-Maharaj, A., Ryan, A., Burnell, M., Lanceley, A., Fraser, L., et al. (2012). Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: impact of age, BMI, hysterectomy, lifestyle and mood in a cross sectional cohort study of 10,418 British women aged 54–65. British Journal of Obstetrics and Gynaecology, 119, 4050.CrossRefGoogle Scholar
Hunter, M. S. and Liao, K. L. M. (1995). A psychological analysis of menopausal hot flushes. British Journal of Clinical Psychology, 34, 589599.CrossRefGoogle ScholarPubMed
Hunter, M. S. and Liao, K. L. M. (1996). Evaluation of a four-session cognitive-behavioural intervention for menopausal hot flushes. British Journal of Health Psychology, 1, 113125.CrossRefGoogle Scholar
Hunter, M. S. and Mann, E. (2010). A cognitive model of menopausal hot flushes and night sweats. Journal of Psychosomatic Research, 69, 491501.CrossRefGoogle ScholarPubMed
Hunter, M. S. and Rendall, M. (2007). Bio-psycho-socio-cultural perspectives on menopause. Best Practice and Research Clinical Obstetrics and Gynaecology, 21, 261274.CrossRefGoogle ScholarPubMed
Lewin, S., Glenton, C. and Oxman, A. D. (2009). Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. British Medical Journal, 339:b3496. doi:10:1136/bmj.b3496CrossRefGoogle ScholarPubMed
Mann, E., Smith, M. J., Balabanovic, J., Hellier, J., Hamed, H., Grunfeld, B., et al. (2012). Efficacy of a cognitive behavioural intervention to treat menopausal symptoms following breast cancer treatment (MENOS 1): a randomised controlled trial. Lancet Oncology, 13, 309318.CrossRefGoogle Scholar
Melby, M. K., Lock, M. and Kaufert, P. (2005). Culture and symptom reporting at menopause. Human Reproductive Update, 11, 495512.CrossRefGoogle ScholarPubMed
Menon, U., Burnell, M., Sharma, A., Gentry-Maharaj, A., Fraser, L., Ryan, A., et al. (2007). Decline in use in hormone therapy among postmenopausal women in the United Kingdom. Menopause: The Journal of the North American Menopause Society, 14, 462467.CrossRefGoogle ScholarPubMed
Rendall, M. J., Simonds, L. M. and Hunter, M. S. (2008). The Hot Flush Beliefs Scale: a tool for assessing thoughts and beliefs associated with the experience of menopausal hot flushes and night sweats. Maturitas, 60, 158169.CrossRefGoogle Scholar
Roese, N. J. and Olson, J. M. (1995). Functions of counterfactual thinking. In Roese, N. and Olson, J. (Eds.), What Might Have Been: the social psychology of counterfactual thinking (pp. 169195). Mahwah, NJ: Erlbaum.Google Scholar
Rossouw, J., Prentice, R., Manson, J., Wu, L., Barad, D., Barnabei, V., et al. (2007). Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA, 297, 14651477.CrossRefGoogle ScholarPubMed
Schwartz, N. and Bless, H. (1992). Constructing reality and its alternatives: an inclusion/exclusion model of assimilation and contrast effects in social judgement. In Martin, L. L. and Tesser, A. (Eds.), The Construction of Social Judgement (pp. 217245). Hillsdale, NJ: Erlbaum.Google Scholar
Smith, J. and Osborn, M. (2008). Interpretative phenomenological analysis. In Smith, J. A. (Ed.), Qualitative Psychology: a practical guide to research methods. Thousand Oaks, CA: Sage Publications.Google Scholar
Smith, J. A., Flowers, P. and Larkin, M. (2009). Interpretative Phenomenological Analysis: theory, method and research. London: Sage.Google Scholar
Teasdale, J. D. (1999). Metacognition, mindfulness and the modification of mood disorders. Clinical Psychology and Psychotherapy, 6, 146155.3.0.CO;2-E>CrossRefGoogle Scholar
Thurston, R., Matthews, K., Hernandez, J. and De La Torre, F. (2009). Improving the performance of physiologic hot flush measures with support vector machines. Psychophysiology, 46, 285292.CrossRefGoogle ScholarPubMed
Wood, J. V., Taylor, J. V. and Lichtman, R. R. (1985). Social comparison in adjustment to breast cancer. Journal of Personality and Social Psychology, 49, 11691183.CrossRefGoogle ScholarPubMed
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