Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-18T06:59:59.391Z Has data issue: false hasContentIssue false
  • English
  • Français

The advanced cancer patient experience of undertaking meaning and purpose (MaP) therapy

Published online by Cambridge University Press:  22 March 2012

Carrie Lethborg ,
Penelope Schofield  and
David Kissane
Carrie Lethborg*
Affiliation:
Oncology Department, Saint Vincent's Hospital, Fitzroy, Victoria, Australia
Penelope Schofield
Affiliation:
Nursing and Supportive Care Research Group, Peter MacCallum Cancer Centre, Melbourne, Australia
David Kissane
Affiliation:
Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
*
Address correspondence and reprint requests to: Carrie Lethborg, Oncology Department, St. Vincent's Hospital, Fitzroy, Victoria, Australia, 3104. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The objective of this study was to describe the experience of undertaking meaning and purpose (MaP) therapy for patients with advanced cancer, with an aim of refining therapeutic processes involved prior to pilot testing. Specifically, we were interested in examining the themes arising from participation in the intervention in relation to our therapeutic goals, and how acceptable both the number of sessions and processes used were.

Method:

A convenience sample of people living with advanced cancer was recruited to participate in this process, resulting in 24 therapy sessions for analysis.

Results:

A thematic analysis of each session illustrated that the process of MaP therapy is one that encourages reflection, offers insights, and can be confrontational, but can also allow participants to “shift” their perspective and focus onto meaningful goals. Results illustrate how the therapist creates a therapeutic frame that holds up a poignant portrayal of the meaning of life lived, and mirrors this to the patient, such that they grasp its rich texture. Participants' descriptions showed how they were buoyed forward as a result, with renewed vigor and enthusiasm, despite their illness and any physical restrictions that it imposed.

Significance of results:

A planned pilot test of this intervention will enable us to determine potential effect sizes of this therapy in reducing distress and increasing meaning prior to a full randomized controlled trial. Understanding the processes involved and the experiences of participation in meaning-based therapies is crucial to the future strength of this area of psychotherapy.

Keywords

Meaning focused interventionTherapeutic processPsychotherapyadvanced cancer patientsPatient experience of psychotherapy
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 3 , September 2012 , pp. 177 - 188
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Antonovsky, A. (1987). Unravelling the Mystery of Health: How People Manage Stress and Stay Well. San Francesco: Jossey- Bass.Google Scholar
Bauer-Wu, S. & Farran, C.J. (2005). Meaning in life and psycho-spiritual functioning. Journal of Holistic Nursing, 23, 172–190.Google Scholar
Breitbart, W., Gibson, C., Poppito, S., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie, 49, 366–372.Google Scholar
Breitbart, W., Rosenfeld, B., Gibson, C., et al. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: A pilot randomized controlled trial. Psycho-oncology, 19, 21–28.Google Scholar
Charon, R. (2004). Narrative and medicine. New England Journal of Medicine, 350, 862–864.Google Scholar
Chochinov, H.M. (2002). Dignity-Conserving Care—A New Model for Palliative Care, Helping the Patient Feel Valued. Journal of the American Medical Association, 297(17), 2253–2260.Google Scholar
Clarke, D. (2003). Faith and hope. Australasian Psychiatry, 11, 164–168.Google Scholar
Cole, B. & Pargament, I.K. (1999). Re-creating your life: A spiritual/psychotherapeutic intervention for people diagnosed with cancer. Psycho-oncology, 8, 395–407.Google Scholar
Danhauer, S.C., Carlson, C.R. & Andrykowski, M.A. (2005). Positive psychosocial functioning in later life: Use of meaning-based coping strategies by nursing home residents. Journal of Applied Gerontology, 24, 299–318.Google Scholar
Davis, C.G., Nolen-Hoeksema, S. & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality & Social Psychology, 75, 561–574.Google Scholar
Folkman, S. & Moskowitz, J.T. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647–654.Google Scholar
Frankl, V. (1963). Man's Search for Meaning: An Introduction to Logotherapy. New York: Washington Square Press.Google Scholar
Frankl, V. (1985). Man's Search for Meaning. New York: Washington Square Press.Google Scholar
Gall, T.L., Guirguis-Youngerm, M., Charbonneau, C., et al. (2009). The trajectory of religious coping across time in response to the diagnosis of breast cancer. Psycho-oncology, 18, 1165–1178.Google Scholar
Goodwin, P.J., Leszcz, M., Ennis, M., et al. (2001). The effect of group psychosocial support on survival in metastatic breast cancer. New England Journal of Medicine, 345, 1719–1726.Google Scholar
Greenstein, M. & Breitbart, W. (2000). Cancer and the experience of meaning: A group psychotherapy program for people with cancer. American Journal of Psychotherapy, 54, 486–500.Google Scholar
Herth, K. (1990). Fostering hope in terminally-ill people. Journal of Advanced Nursing, 15, 1250–1259.Google Scholar
Holland, J., Poppito, S., Nelson, C., et al. (2009). Reappraisal in the eighth life cycle stage: A theoretical psychoeducational intervention in elderly patient with cancer. Palliative & Supportive Care, 7, 271–279.Google Scholar
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7, 113–136.Google Scholar
Kissane, D.W., Grabsch, B., Clarke, D.M., et al. (2007). Supportive-expressive group therapy for women with metastatic breast cancer: Survival and psychosocial outcome from a randomized controlled trial. Psycho-Oncology, 16, 227–286.Google Scholar
Lawton, J. (1998). Contemporary hospice care: The sequestration of the unbounded body and “dirty dying.” Sociology of Health and Illness, 20, 121–143.Google Scholar
Lee, V., Cohen, S.R., Edgar, L., et al. (2004). Clarifying “meaning” in the context of cancer research: A systematic literature review. Palliative and Supportive Care, 2, 291–303.Google Scholar
Lethborg, C., Aranda, S., Bloch, S., et al. (2006). The role of meaning in advanced cancer – Integrating the constructs of assumptive world, sense of coherence and meaning-based coping. Journal of Psychosocial Oncology, 24, 27–42.Google Scholar
Lethborg, C., Aranda, S. & Kissane, D. (2007). To what extent does meaning mediate adaptation to cancer? — The relationship between physical suffering, meaning in life and connection to others in adjustment to cancer. Palliative and Supportive Care, 5, 377–388.Google Scholar
Lethborg, C., Aranda, S. & Kissane, D. (2008). Meaning in adjustment to cancer: A model of care, Palliative & Supportive Care, 6, 61–70.Google Scholar
McKnight, P.E. & Kashdan, T.B. (2009). Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory. Review of General Psychology, 13, 242–251.Google Scholar
Meraviglia, M. (2006). Effects of spirituality in breast cancer survivors. Oncology Nursing Forum, 33, E1–E7.Google Scholar
Mishler, E. (1986). Research Interviewing: Context and Narrative. Cambridge: Harvard University Press.Google Scholar
Park, C. & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115–144.Google Scholar
Patton, M.Q. (1990). Qualitative Evaluation and Research Methods. Newbury Park, CA: Sage.Google Scholar
Richer, M-C. & Ezer, H. (2002). Living in it, living with it and moving it on: Dimensions of meaning during chemotherapy. Oncology Nursing Forum, 29, 113–119.Google Scholar
Soelle, D. (1975). Suffering (Kalin, E.R., Trans.). Philadelphia: Fortress Press.Google Scholar
Spiegel, D., Bloom, J.R., Kraemer, H.C., et al. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888–891.Google Scholar
Spiegel, D., Butler, L., Giese-Davis, J., et al. (2007). Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer. Cancer, 110, 1130–1138.Google Scholar
Spira, J.L. (2000). Existential psychotherapy in palliative care. In Handbook of Psychiatry in Palliative Medicine. Chochinov, H. & Breitbart, W. (ed.), New York: Oxford University Press, 197–213.Google Scholar
Vickberg, S.M., DuHamel, K.N., Smith, M.Y., et al. (2001). Global meaning and psychological adjustment among survivors of bone marrow transplant. Psycho-oncology, 10, 29–39.Google Scholar
Viederman, M. (1983). Psychodynamic life narrative in a psychotherapeutic intervention useful in crisis situations. Psychiatry, 46, 236–246.Google Scholar
Weber, R.P. (1990). Basic Content Analysis. Newbury Park, CA: Sage.Google Scholar
White, M. (1990). Narrative Means to Therapeutic Ends. New York: Norton.Google Scholar
White, M. (1997). Narratives of Therapists' Lives. Adelaide: Dulwich.Google Scholar
Yalom, I.D. (1980). Existential Psychotherapy. New York: Basic Books.Google Scholar