Spirituality and its role in end-of-life care has recently emerged as a central issue in palliative care. There have been several recent studies of terminally ill cancer and AIDS patients by our research group demonstrating the central role of spiritual well being, and """"""""meaning"""""""" in particular, in buffering against depression, hopelessness, and desire for hastened death. Spirituality can be defined as a construct involving components of both faith and/or meaning. Interventions based on the faith/religious component of spirituality have limited acceptance by health care practitioners and patients. Interventions based on the meaning component of spirituality may have more universal acceptance and applicability. We have developed and manualized an 8-week Meaning-Centered Group Psychotherapy, based on the principles of Viktor Frankl's Logotherapy, designed to help patients with advanced cancer sustain or enhance a sense of meaning, peace and purpose as they approach the end-of-life. This project's overall aim is to explore the efficacy of this new and unique psychotherapy intervention for advanced cancer patients in enhancing psychological and spiritual well being and quality of life. Specifically, we will preliminarily examine the efficacy of Meaning-Centered Group Psychotherapy, compared to a standard supportive group psychotherapy, in enhancing spiritual well being and quality of life and reducing psychological distress. 118 advanced cancer patients will be randomized to receive one of these two interventions. In addition, we will explore the relationships among-spiritual well being, psychological distress, hopelessness, physical symptom severity and distress, quality of life, and perceived social support. Subjects will be assessed with a battery of self-report measures at baseline (point of accrual), prior to intervention, post-intervention, and at 3 month follow-up. This study will provide essential preliminary efficacy data on a novel and innovative psychotherapy intervention for patients with advanced cancer, incorporating spiritual (meaning-centered) elements, which holds great promise in the treatment of spiritual suffering at the end-of-life. Larger, randomized controlled trials of Meaning-Centered Group Psychotherapy will be conducted in the future utilizing the insights learned from this pilot intervention study.
| Lichtenthal, Wendy G; Breitbart, William (2015) The central role of meaning in adjustment to the loss of a child to cancer: implications for the development of meaning-centered grief therapy. Curr Opin Support Palliat Care 9:46-51 |
| Saracino, Rebecca; Kolva, Elissa; Rosenfeld, Barry et al. (2015) Measuring social support in patients with advanced medical illnesses: An analysis of the Duke-UNC Functional Social Support Questionnaire. Palliat Support Care 13:1153-63 |
| Breitbart, William; Poppito, Shannon; Rosenfeld, Barry et al. (2012) Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. J Clin Oncol 30:1304-9 |
| Breitbart, William; Rosenfeld, Barry; Gibson, Christopher et al. (2010) Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psychooncology 19:21-8 |
