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Emotional processing during psychotherapy among women newly diagnosed with a gynecological cancer

Published online by Cambridge University Press:  14 December 2016

Sharon L. Manne ,
Shannon Myers-Virtue ,
Katie Darabos ,
Melissa Ozga ,
Carolyn Heckman ,
David Kissane  and
David Rotter
Sharon L. Manne*
Affiliation:
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
Shannon Myers-Virtue
Affiliation:
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
Katie Darabos
Affiliation:
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
Melissa Ozga
Affiliation:
Memorial Sloan Kettering Cancer Center, New York, New York
Carolyn Heckman
Affiliation:
Fox Chase Cancer Center, Philadelphia, Pennsylvania
David Kissane
Affiliation:
Monash University, Melbourne, Victoria, Australia
David Rotter
Affiliation:
Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
*
Address correspondence and reprint requests to: Sharon Manne, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, New Jersey 08903. E-mail: [email protected].
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Abstract

Objective:

Our aim was to compare changes in emotional processing by women newly diagnosed with gynecological cancer enrolled in either a coping and communication skills intervention (CCI) or a supportive counseling (SC) intervention. We examined the association between in-session emotional processing and patient-rated therapeutic progress.

Method:

Three therapy sessions with 201 patients were rated for the depth of emotional processing (peak and mode) during emotion episodes (EEs) using the Experiencing Rating Scale (EXP). Participants completed measures of dispositional emotional expressivity, depressive symptoms, and cancer-related distress before treatment began, as well as ratings of perceived progress in therapy after each session.

Results:

Peak EXP ratings averaged between 2.7 and 3.1, indicating that women discussed events, their emotional reactions, and their private experiences in sessions. A small proportion of patients had high levels of processing, indicating deeper exploration of the meaning of their feelings and experiences. Women in SC were able to achieve a higher level of emotional processing during the middle and later sessions, and during cancer-related EEs in the later session. However, emotional processing was not significantly associated with a patient's perceived therapeutic progress with SC. In the CCI group, higher levels of emotional processing were associated with greater session progress, suggesting that it may play an important role in patient-rated treatment outcomes.

Significance of results:

Newly diagnosed gynecological cancer patients are able to attend to their emotions and personal experiences, particularly when discussing cancer-related issues during both short-term SC and prescriptive coping skills interventions.

Keywords

Emotional processingGynecological cancerPsychotherapy
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 4 , August 2017 , pp. 405 - 416
Copyright
Copyright © Cambridge University Press 2016 

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References

REFERENCES

Beck, A.T., Ward, C.H., Mendelson, M., et al. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. Available from http://counsellingresource.com/lib/wp-content/managed-media/Beck_AT_1961.pdf.Google Scholar
Castonguay, L.G., Goldfried, M.R., Wiser, S., et al. (1996). Predicting the effect of cognitive therapy for depression: A study of unique and common factors. Journal of Consulting and Clinical Psychology, 64(3), 497–504.CrossRefGoogle ScholarPubMed
Elliott, R., Watson, J.C., Goldman, R.N., et al. (2004). Learning emotion-focused therapy: The process-experiential approach to change. Washington D.C.: American Psychological Association.CrossRefGoogle Scholar
Epping-Jordan, J., Compas, B. & Howell, D. (1994). Predictors of cancer progression in young adults men and women: Avoidance, intrusive thoughts and psychological symptoms. Health Psychology, 13(6), 539–547.CrossRefGoogle ScholarPubMed
Feldman, G., Harley, R., Kerrigan, M., et al. (2009). Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder. Behaviour Research and Therapy, 47(4), 316–321. Epub ahead of print Jan 17.CrossRefGoogle Scholar
Fitzpatrick, M., Peternelli, L., Stalikas, A., et al. (1999). Client involvement and occurrence of in-session therapeutic phenomena. Canadian Journal of Counselling, 33, 179–191.Google Scholar
Gendlin, E.T., Beebe, J., Cassens, J., et al. (1968). Focusing ability in psychotherapy, personality, and creativity. In Research in psychotherapy, Vol. 3. Schlien, J.M. (ed.), pp. 217–241. Washington, D.C.: American Psychological Association.CrossRefGoogle Scholar
Greenberg, L. (2002). Emotion-focused therapy: Coaching clients to work through feelings. Washington, D.C.: American Psychological Association.CrossRefGoogle Scholar
Greenberg, L.S. & Korman, L. (1993). Assimilating emotion into psychotherapy integration. Journal of Psychotherapy Integration, 3(3), 249–265.Google Scholar
Greenberg, L.S. & Pascual-Leone, J. (1995). A dialectical constructivist approach to experiential change. In Constructivism in psychotherapy. Neimeyer, R. & Mahoney, M. (eds.), pp. 169–191. Washington, D.C.: American Psychological Association.Google Scholar
Greenberg, L.S. & Safran, J.D. (1984). Integrating affect and cognition: A perspective on the process of therapeutic change. Cognitive Therapy and Research, 8(6), 559–578.Google Scholar
Greenberg, L. & Safran, J. (1987). Emotion in psychotherapy: Affect, cognition, and the process of change. New York: Guilford Press.Google Scholar
Greenberg, L., Rice, L. & Elliott, R. (1993). The moment-by-moment process: Facilitating emotional change. New York: Guilford Press.Google Scholar
Hipkins, J., Whitworth, M., Tarrier, N., et al. (2004). Social support, anxiety and depression after chemotherapy for ovarian cancer: A prospective study. British Journal of Health Psychology, 9(Pt. 4), 569–581.CrossRefGoogle ScholarPubMed
Hobbie, W.L., Stuber, M., Meeske, K., et al. (2000). Symptoms of posttraumatic stress in young adult survivors of childhood cancer. Journal of Clinical Oncology, 18(24), 4060–4066.CrossRefGoogle ScholarPubMed
Horowitz, M., Wilner, N. & Alvarez, W. (1979). Impact of the Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41(3), 209–218.CrossRefGoogle Scholar
Hunt, M.G. (1998). The only way out is through: Emotional processing and recovery after a depressing life event. Behaviour Research and Therapy, 36(4), 361–384.CrossRefGoogle ScholarPubMed
Hwang, K.H., Cho, O. & Yoo, Y. (2016). Symptom clusters of ovarian cancer patients undergoing chemotherapy, and their emotional status and quality of life. European Journal of Oncology Nursing, 21, 215–222. Epub ahead of print Nov 29, 2015.Google Scholar
King, L.A. & Emmons, R.A. (1990). Conflict over emotional expression: Psychological and physical correlates. Journal of Personality and Social Psychology, 58(5), 864–877.CrossRefGoogle ScholarPubMed
Klein, M.H., Mathieu, P.L., Gendlin, E.T., et al. (1969). The Experiencing Scale: A research and training manual. Madison: Wisconsin Psychiatric Institute.Google Scholar
Klein, M., Mathieu-Coughlan, P. & Kiesler, D.J. (1986). The experiencing scale. In The psychotherapeutic process: A research handbook. Greenberg, L.S. & Pinsof, W.M. (eds.), pp. 21–106. New York: Guilford Press.Google Scholar
Kolden, G.G. (1991). The generic model of psychotherapy: An empirical investigation of patterns of process and outcome relationships. Psychotherapy Research, 1(1), 62–73.Google Scholar
Korman, L.M. (1991). Emotion episodes. Master's thesis. North York: York University.Google Scholar
Korman, L.M. (1998). Changes in clients' emotion episodes in therapy. Doctoral dissertation. North York: York University. Available from http://www.collectionscanada.gc.ca/obj/s4/f2/dsk2/tape15/PQDD_0019/NQ27300.pdf.Google Scholar
Luborsky, L., Chandler, M., Auerbach, A.H., et al. (1970). Factors influencing the outcome of psychotherapy: A review of quantitative research. Psychological Bulletin, 75(3), 145–185.CrossRefGoogle Scholar
Manne, S.L., Winkel, G., Rubin, S., et al. (2008). Mediators of a coping and communication-enhancing intervention and a supportive counseling intervention among women diagnosed with gynecological cancers. Journal of Consulting and Clinical Psychology, 76(6), 1034–1045. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710766/.CrossRefGoogle Scholar
Myers Virtue, S., Manne, S.L., Darabos, K., et al. (2015). Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers. Psycho-Oncology, 24(9), 1189–1196. Epub ahead of print Dec 17, 2014. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470875/.Google Scholar
Norton, T.R., Manne, S.L., Rubin, S., et al. (2004). Prevalence and predictors of psychological distress among women with ovarian cancer. Journal of Clinical Oncology, 22(5), 919–926. Available from http://jco.ascopubs.org/content/22/5/919.full.pdf+html.Google Scholar
Novalis, P.N., Rojcewicz, S.J. & Peele, P. (1993). Clinical manual of supportive psychotherapy. Washington, D.C.: American Psychiatric Press.Google Scholar
Orlinsky, D.E & Howard, K.I. (1986). Process and outcome in psychotherapy. In Handbook of psychotherapy and behavioral change: An empirical analysis, 3rd ed. Garfield, S. & Gergin, A. (eds.), pp. 311–385. New York: John Wiley.Google Scholar
Pascual-Leone, A. (2009). Dynamic emotional processing in experiential therapy: Two-steps forward, one step back. Journal of Consulting and Clinical Psychology, 77, 113–126.CrossRefGoogle ScholarPubMed
Pos, A. E., Greenberg, L. S., Goldman, R. N., et al. (2003). Emotional processing during experiential treatment of depression. Journal of Consulting and Clinical Psychology, 77(1), 1007–1016.Google Scholar
Rice, L.N. & Greenberg, L.S. (1984). Patterns of change. New York: Guilford Press.Google Scholar
Schag, C.A., Ganz, P.A. & Heinrich, R.L. (1991). Cancer Rehabilitation Evaluation System–Short Form (CARES–SF): A cancer-specific rehabilitation and quality of life instrument. Cancer, 68(6), 1406–1413. Available from http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(19910915)68:6%3C1406::AID-CNCR2820680638%3E3.0.CO;2-2/pdf.Google Scholar
Stanton, A.L., Danoff-Burg, S., Cameron, C.L., et al. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68(5), 875–882. Available from https://www.apa.org/pubs/journals/releases/ccp685875.pdf.Google Scholar
Watson, D., Clark, L.A. & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.CrossRefGoogle ScholarPubMed
Watson, J.C. & Bedard, D.L. (2006). Clients' emotional processing in psychotherapy: A comparison between cognitive behavioral and process-experiential therapies. Journal of Consulting and Clinical Psychology, 74(1), 152–159.CrossRefGoogle ScholarPubMed
Watts, S., Prescott, P., Mason, J., et al. (2015). Depression and anxiety in ovarian cancer: A systematic review and meta-analysis of prevalence rates. BMJ Open, 5(1), e007618. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4679843/.Google Scholar
Wiser, S. & Goldfried, M.R. (1993). Comparative study of emotional experiencing in psychodynamic interpersonal and cognitive behavioral therapies. Journal of Consulting and Clinical Psychology, 61(5), 892–895.Google Scholar