Meaning-Centered Psychotherapy

2021 ◽  
pp. 489-494
Author(s):  
Melissa Masterson Duva ◽  
Wendy G. Lichtenthal ◽  
Allison J. Applebaum ◽  
William S. Breitbart
Keyword(s):  
End Of Life ◽  
Advanced Cancer ◽  
Psychosocial Care ◽  
Well Being ◽  
Cancer Center ◽  
Existential Psychology ◽  
Patients With Cancer ◽  
Spiritual Well Being ◽  
The Face

Existential concerns carry significant distress, particularly among patients with advanced cancer. For patients who are facing death, a sense of meaning—and the preservation of that meaning—is not only clinically and existentially important but also central to providing holistic, high-quality end-of-life care. Nearly two decades ago, the authors’ research group at Memorial Sloan Kettering Cancer Center began to understand that a meaning-centered approach to psychosocial care was imperative to alleviate the existential distress that plagued many patients with advanced cancer. Based on Viktor Frankl’s work on the importance of meaning and principles of existential psychology and philosophy, they developed Meaning-Centered Psychotherapy (MCP) to help patients with advanced cancer sustain or enhance a sense of meaning, peace, and purpose in their lives in the face of terminal cancer. This chapter provides an overview of MCP in working with patients with cancer. It summarizes the ever-growing body of research that has demonstrated the effectiveness of MCP in improving meaning, spiritual well-being, and quality of life and in reducing psychological distress and despair at end of life. Adaptations of MCP for other purposes and populations, such as cancer survivors, caregivers, and bereavement, are mentioned but are elaborated on in other specific chapters related to these issues in this textbook.

Meaning-Centered Group Psychotherapy for Patients with Advanced Cancer

2015 ◽  
Author(s):  
William S. Breitbart ◽  
Shannon R. Poppito
Keyword(s):  
Group Psychotherapy ◽  
Advanced Cancer ◽  
Well Being ◽  
Cancer Center ◽  
Advanced Cancer Patients ◽  
Expression Of Emotion ◽  
Spiritual Well Being ◽  
The Face ◽  
Desire For Death

The importance of spiritual well-being and the role of "meaning" in moderating depression, hopelessness and desire for death in terminally-ill cancer and AIDS patients has been well-supported by research, and has led many palliative clinicians to focus on the development of non-pharmacologic interventions that can help their patients address these issues. Individual Meaning-Centered Group Psychotherapy (IMCP), an intervention developed and rigorously tested by the Department of Psychiatry & Behavioral Sciences at Memorial Sloan-Kettering Cancer Center, is a seven-week program based around the work of Viktor Frankl, and which utilizes a mixture of didactics, discussion and experiential exercises that focus around particular themes related to meaning and advanced cancer. Patients are assigned readings and homework that are specific to each session's theme and which are utilized in each session. While the focus of each session is on issues of meaning and purpose in life in the face of advanced cancer and a limited prognosis, elements of support and expression of emotion are inevitable in the context of each group session.

Individual Meaning-Centered Psychotherapy for Advanced Cancer Patients

2017 ◽  
Author(s):  
William Breitbart ◽  
Wendy G. Lichtenthal ◽  
Allison J. Applebaum ◽  
Melissa Masterson
Keyword(s):  
Clinical Trials ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Therapeutic Intervention ◽  
Well Being ◽  
Existential Psychology ◽  
Advanced Cancer Patients ◽  
Spiritual Well Being ◽  
Existential Concerns

Among the advanced cancer population, existential concerns are major issues that promote significant distress. For patients who are facing death, meaning and the preservation of meaning are not only clinically and existentially important but also central concepts to a therapeutic intervention. Based on Viktor Frankl’s logotherapy and the principles of existential psychology and philosophy, “meaning-centered psychotherapy” was developed to help patients with advanced cancer sustain or enhance a sense of meaning, peace, and purpose in their lives. This chapter provides an overview of work developing and testing individual meaning-centered psychotherapy (IMCP). It provides an overview of the session content in the IMCP intervention. It also presents findings from clinical trials, which support the efficacy of IMCP as an intervention to increase a sense of meaning, spiritual well-being, and hope while decreasing end-of-life despair. Furthermore, it presents difficult scenarios that may arise when delivering IMCP for clinicians interested in this work.

scholarly journals The Need for Culturally Congruent Psychosocial Care for Muslims With Advanced Cancer in Non-Muslim Majority Settings

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 115s-115s
Author(s):  
M. Lazenby ◽  
Z. Alward ◽  
R. Gatarny ◽  
C. Ayash ◽  
F. Gany
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Functional Assessment ◽  
Psychosocial Care ◽  
Well Being ◽  
Beliefs And Practices ◽  
Culturally Congruent ◽  
Spiritual Well Being ◽  
Muslim Majority

Background: Little is known about the psychosocial care experience of Muslims who are in treatment of advanced cancer in non-Muslim majority settings. Aim: To describe the experience of Muslims who are in treatment of advanced cancer in a non-Muslim majority setting and to identify beliefs and practices for culturally congruent psychosocial care. Methods: This cross-sectional study, which is in progress, uses a semistructured interview guide and self-report questionnaires with Muslim patients ≥ 21 years who are in treatment of stage III or IV cancer at an academic cancer center in the northeast of the United States. Analysis of interviews is by grounded theory and of questionnaires by frequencies, percentages, and measures of central tendency and dispersion for quality of life: Functional Assessment of Cancer Therapy-General (FACT-G; range 0-108) with subscales: Physical Well-Being (PWB [range 0-28]), Social Well-Being (SWB [range 0-28]), Emotional Well-Being (EWB [range 0-24]), and Functional Well-Being (FWB [range 0-28]; higher scores reflect better quality of life Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp [range 0-48]), with subscales: peace (range 0-16), meaning (range 0-16), and faith (range 0-16); higher scores reflect better spiritual well-being. Distress Thermometer (DT; 0 = no distress, 10 = worst distress). Hospital Anxiety and Depression Scale (HADS), with subscale: anxiety (0-21) and depression (0-21); higher scores reflect worse condition. Results: Eleven (female, n=5 [45.5%]) Muslim patients from 10 countries of origin with a mean age of 55.2 (±10.9) years who were in treatment of breast, colorectal, gastric, lung, ovarian, prostate, melanoma and lymphoma cancers (Stage 4, n=8 [72.7%]) have been interviewed to date. Mean scores were: FACT-G 85.6 (±17.9) (PWB 22.3 [±5.1], SWB 23.8 [±3.8], EWB 18.6 [±4.5], FWB 20.7 [±6.7]; FACIT-Sp 123.8 (±24.6) (peace 11.6 [±4.5], meaning 13.7 [±3.1], faith 12.9 [±3.8]), DT 2.13 (SD 2.58); HADS anxiety 3.9 (±3.2) and depression 3.8 (±3.7). Four universal themes emerged: (1) Faithful Muslims must seek and submit to treatment. (2) Spiritual practices (prayer and other traditional healing practices) are sources of meaning. (3) Psychosocial care in a non-Muslim majority setting is often presented in ways incongruent with Muslims' beliefs and practices. (4) Psychosocial care would be acceptable if congruent with Muslims' beliefs and practices. Conclusion: Presenting psychosocial care as part of routine cancer treatment and, in non-Muslim majority settings, delivering psychosocial care that is culturally congruent with Islamic beliefs and practices, may increase the acceptability of psychosocial care among Muslims who are in treatment of advanced cancer.

scholarly journals Fears, beliefs, and quality of life of patients with cancer vs the general population during the coronavirus disease 2019 (COVID-19) pandemic in Lombardy

2021 ◽  
pp. 030089162110228
Author(s):  
Carla Ida Ripamonti ◽  
Giacomo Massa ◽  
Daniela Insolvibile ◽  
Mauro Guglielmo ◽  
Guido Miccinesi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Perceived Risk ◽  
Well Being ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Psychological Consequences ◽  
Patients With Cancer ◽  
Fear Of Cancer

Aim: To understand how patients with cancer reacted to the coronavirus disease 2019 (COVID-19) pandemic and whether their quality of life (QoL) was affected. Methods: In June 2020, 111 patients with cancer treated in the supportive care unit of a Comprehensive Cancer Center in Milan and 201 healthy controls from the general population were enrolled and assessed both quantitatively and qualitatively for fears and COVID-19–related beliefs as well as for QoL. Results: Fear of COVID-19 was significantly lower among patients (41% vs 57.6%; p = 0.007), as was fear of cancer (61.5% vs 85.6%; p < 0.001) and other diseases. The perceived risk of getting COVID-19 was lower among patients (25.2% vs 52.7%; p < 0.001), as was the belief of having been exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (18.1% vs 40.8%; p < 0.001). The physical component of QoL was better among the population (54.5 vs 43.8; p < 0.001); the reverse was true for patients’ psychological well-being (44.6 vs 39.6; p < 0.001). The qualitative data supported such results, showing a reduced psychological effect on the patients with cancer compared to the controls. Various reasons explain this result, including the awareness of being treated for cancer and nevertheless protected against getting infected in a cancer center of public health reorganized to continue treating patients by protecting them and personnel from the risk of infection. Conclusions: The experience of a cancer diagnosis, together with proper hospital reorganization, may act as protective factors from fears and psychological consequences of the COVID-19 outbreak.

Assessment of Quality of Life in Outpatients With Advanced Cancer: The Accuracy of Clinician Estimations and the Relevance of Spiritual Well-Being—A Hoosier Oncology Group Study

2003 ◽  
Vol 21 (14) ◽  
pp. 2754-2759 ◽  
Author(s):  
Michael J. Fisch ◽  
Michael L. Titzer ◽  
Jean L. Kristeller ◽  
Jianzhao Shen ◽  
Patrick J. Loehrer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Performance Status ◽  
Well Being ◽  
Categorical Variables ◽  
Therapeutic Trial ◽  
Slight Variation ◽  
Cross Sectional ◽  
Spiritual Well Being

Purpose: To evaluate the association between quality-of-life (QOL) impairment as reported by patients and QOL impairment as judged by nurses or physicians, with and without consideration of spiritual well-being (SWB). Patients and Methods: A total of 163 patients with advanced cancer were enrolled onto a therapeutic trial, and cross-sectional data were derived from clinical and demographic questionnaires obtained at baseline, including assessment of patient QOL and SWB. Clinicians rated the QOL impairment of their patients as mild, moderate, or severe. Clinician-estimated QOL impairment and patient-derived QOL categories were compared. Correlation coefficients were estimated to associate QOL scores using different instruments. The analysis of variance method was used to compare Functional Assessment of Cancer Therapy–General scores on categorical variables. Results: There was no significant association between self-assessment scores and marital status, education level, performance status, or predicted life expectancy. However, a strong relationship between SWB and QOL was noted (P < .0001). Clinician-estimated QOL impairment matched the level of patient-derived QOL correctly in approximately 60% of cases, with only slight variation depending on the method of categorizing patient-derived QOL scores. The accuracy of clinician estimates was not associated with the level of SWB. Interestingly, a subset analysis of the inaccurate estimates revealed an association between lower SWB and clinician underestimation of QOL impairment (P = .0025). Conclusion: Clinician estimates of QOL impairment were accurate in more than 60% of patients. SWB is strongly associated with QOL, but it is not associated with the overall accuracy of clinicians’ judgments about QOL impairment.

Spirituality and religion in terminally ill patients with cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19587-19587
Author(s):  
P. Heras ◽  
K. Kritikos ◽  
A. Georgopoulou ◽  
A. Hatzopoulos ◽  
N. Kritikos
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Well Being ◽  
Negative Association ◽  
Terminally Ill Cancer Patients ◽  
Patients With Cancer ◽  
Spirituality And Religion ◽  
Spiritual Well Being ◽  
Strong Negative Association

19587 Background: The importance of spirituality and religion in coping with a terminal illness is becoming increasingly recognised. We aimed to assess the relation between spiritual well-being, religiosity, depression, and end-of-life despair in terminally-ill cancer patients. Methods: One hundred forty three terminally ill cancer patients with a life expectancy of less than 6 months were interviewed with a series of standardised instruments, including the FACIT Spiritual Well-Being Scale, a religiosity index similar to those used in previous research, the Hamilton depression rating scale, the Memorial Symptom Assessment Scale and the Duke-UNC Functional Social Support Questionnaire. Results: A strong negative association was observed between the FACIT Spiritual Well-Being scale and the HDRS, but no such relationship was found for religiosity. Similar patterns were observed for the FACIT subscales, finding a strong negative association between the meaning and peace subscale (which corresponds to the more existential aspects of spirituality) and HDRS scores, whereas a positive, albeit nonsignificant, association was observed for the faith subscale (which corresponds more closely to religiosity). Conclusions: These results suggest that the beneficial aspects of religion may be primarily those that relate to spiritual well-being rather than to religious practices per se. Spiritual well-being offers some protection against end-of-life despair in those for whom death is imminent. The area of spiritual work is fertile ground for further investigation, especially interventions aimed at improving spiritual health and general quality of life among terminally ill patients with cancer. No significant financial relationships to disclose.

scholarly journals Pilot Randomized Controlled Trial of Individual Meaning-Centered Psychotherapy for Patients With Advanced Cancer

2012 ◽  
Vol 30 (12) ◽  
pp. 1304-1309 ◽  
Author(s):  
William Breitbart ◽  
Shannon Poppito ◽  
Barry Rosenfeld ◽  
Andrew J. Vickers ◽  
Yuelin Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Symptom Burden ◽  
Well Being ◽  
Treatment Assessment ◽  
Spiritual Well Being ◽  
Secondary Outcomes ◽  
Anxiety Depression

Purpose Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer. Patients and Methods Patients with stage III or IV cancer (N = 120) were randomly assigned to seven sessions of either IMCP or therapeutic massage (TM). Patients were assessed before and after completing the intervention and 2 months postintervention. Primary outcome measures assessed spiritual well-being and quality of life; secondary outcomes included anxiety, depression, hopelessness, symptom burden, and symptom-related distress. Results Of the 120 participants randomly assigned, 78 (65%) completed the post-treatment assessment and 67 (56%) completed the 2-month follow-up. At the post-treatment assessment, IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being (b = 0.39; P <.001, including both components of spiritual well-being (sense of meaning: b = 0.34; P = .003 and faith: b = 0.42; P = .03), and quality of life (b = 0.76; P = .013). Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden (b = −6.56; P < .001) and symptom-related distress (b = −0.47; P < .001) but not for anxiety, depression, or hopelessness. At the 2-month follow-up assessment, the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group. Conclusion IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being.

The meaning of dignity in psychosocial care

2018 ◽  
Author(s):  
Susan McClement ◽  
Genevieve Thompson
Keyword(s):  
Psychosocial Care ◽  
Holistic Approach ◽  
Well Being ◽  
Physical Symptoms ◽  
Clinical Encounters ◽  
Life Threatening Illness ◽  
Whole Person ◽  
Spiritual Well Being ◽  
Life Threatening

Individuals living with life-limiting illness experience a myriad of physical, psychosocial and existential challenges. Psychosocial care is an holistic approach that aims to mitigate the distress engendered by these challenges. One important facet of such care includes tending to patient dignity. This chapter discusses what dignity is, why it is important, and how dignity conserving care can be weaved into daily clinical encounters. Palliative care is a type of health care for individuals facing life-threatening illness and their families that involves ongoing evaluation and management of a person’s pain and other physical symptoms. It also involves the provision of psychosocial care—care that attends to a person’s emotional, social, and spiritual well-being. This whole-person approach to the care of individuals is concerned with addressing a range of needs that can improve quality of life.

scholarly journals Associations Between The Spiritual Well-Being (EORTC QLQ-SWB32) and Quality of Life (EORTC QLQ-C30) of Patients Receiving Palliative Care for Cancer in Cyprus

2021 ◽  
Author(s):  
Maria Kyranou ◽  
Marianna Nicolaou
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Well Being ◽  
Cancer Data ◽  
Patients With Cancer ◽  
Spiritual Well Being ◽  
Eortc Qlq C30 ◽  
The Mean ◽  
Eortc Qlq

Abstract Background: Spiritual well-being is increasingly investigated in relation to patients’ perceived quality of life and is generally thought as having the potential to support patients with cancer who receive palliative care. Until recently, questionnaires used to assess spiritual well-being were developed mainly in the US. The purpose of this study was to translate and use the EORTC- SWB32, a newly developed tool, validated recently in 4 continents, 14 countries, and in 10 languages, to explore relationships of spiritual well-being with quality of life in patients with cancer.Methods: One hundred four patients participated in this study with an average age of 59 years. Of those, 79% were dealing with metastatic cancer. Data collection took place in three oncology centers from two large cities in Cyprus. The acceptability of the translated items was tested. Two questionnaires were employed for the assessment of quality of life and spiritual well-being, developed by the same organization: the EORTC QLQ-C30 and the EORTC QLQ-SWB32. The scores for each tool were analyzed separately and correlations between the two measures were explored. Results: Patients found the items of the SWB32 tool easy to understand and answer. They attested that filling the questionnaire prompted thoughts about their own spirituality. The mean score for Global Spiritual Well-Being was 60.4 (SD=23.7) and it was associated with the mean scores in the scales “Emotional functioning” and “Cognitive functioning” of the EORTC-QOL-C30 (0.42 and 0.40 respectively, p<0.01). The mean score for the “Relationship with God” scale (74.9, SD=29.7) reported by the Cypriot patients is high and compatible with the homogenous spiritual orientation of the island’s population.Conclusions: All subscales of the SWB32 tool demonstrated good internal consistency in this study. Significant associations were observed between dimensions of quality of life and spiritual well-being. Additionally, the participants found the items easy to answer consistent with the tool’s suggested clinical utility which lays the ground for the application of targeted interventions to enhance spiritual well-being.

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