Group psychotherapy for medical patients

Mothers with breast cancer: A mixed-method systematic review on the impact on the parent-child relationship

OBJECTIVE

To systematically review and integrate the findings from quantitative and qualitative studies on parenting and parent-child relationships in families where mothers had breast cancer (BC).

METHODS

Ten different databases were searched from inception to January 2016. All authors assessed these data independently. Full-text, peer-reviewed articles exploring parenting and/or mother-child relationships in families where the mother had BC, regardless of cancer stage, were considered for inclusion. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.

RESULTS

From 116 studies, 23 were deemed eligible for inclusion. Five of them were quantitative, 15 were qualitative, and 1 study used a mixed-method approach. Most studies analysed the mother's perceptions about the experience of having BC in parenting and in the parent-child relationship. The majority of studies explored experiences and perspectives on the parent-child relationship in mothers with minor children, although a minority of studies included adult children. Additionally, a few studies (17%) addressed perceptions and experiences of women with advanced stage cancer. Three main themes were found: priorities and concerns of patients, decision-making processes about sharing the diagnosis with their children, and mother-child relationship and parenting after mother's diagnosis.

CONCLUSIONS

Findings indicated that the diagnosis of BC is accompanied by an array of challenges that affect parental roles and parenting. Further studies are needed to explore these issues more sensitively. For now, however, the evidence suggests that the families of women with BC, and particularly the women themselves, may benefit from informal and formal support aimed at helping them cope effectively with this challenging life event.

Group Interventions for Patients with Cancer and HIV Disease: Part I: Effects on Psychosocial and Functional Outcomes at Different Phases of Illness

Group interventions for individuals facing cancer or HIV disease have drawn considerable attention among researchers and clinicians over the past 20 years. There is growing evidence that group services may be helpful, but which interventions are most effective for participants at which phases in the trajectory of disease has been less clear. Moreover, professionals working in different intervention settings (e.g., primary prevention vs. clinical care) and different disease sites (cancer vs. HIV disease) often have little awareness of relevant advances in other fields. Efforts to integrate findings in the literature may accelerate research and advance the standard of clinical care. The current article, the first in a series of four special reports, critically evaluates the efficacy of group interventions led by professional or trained facilitators for individuals confronted by cancer or HIV, across the spectrum of illness from elevated risk through advanced disease. We examine psychosocial and functional outcomes for different interventions directed toward different patient subgroups, trace common themes, highlight limitations, and offer recommendations for further research.

Efficacy and medical cost offset of psychosocial interventions in cancer care: Making the case for economic analyses

The burden of cancer in the worldwide context continues to grow, as incidence and mortality increase each year. Regardless of where they live, a significant proportion of cancer patients at all stages of the disease trajectory will suffer social, emotional and psychological morbidity as a result of their diagnosis and treatment. Psychosocial interventions have proven efficacious in helping patients and families overcome many of the challenges that arise consequent to a cancer diagnosis. Addressing psychosocial needs is an essential aspect of any model of adequate cancer care, however it may also prove to be a cornerstone in efforts to extend the reach of cost-effective cancer treatment to meet the growing global need. In order to set the stage for discussion of economic issues, this paper first briefly reviews the literature detailing the extent of distress and the efficacy of psychosocial treatments for cancer patients. This is followed by a summary of terminology and costing concepts in the economic evaluation of psychosocial treatments, and a review of the literature on medical cost offset in mental health, other medical populations, and in cancer patients. The literature clearly supports the notion that psychosocial interventions are not only effective, but also economical. Conclusions support adding costing data into evaluations of the efficacy of psychosocial treatments in order to detail the often present but usually overlooked long-term cost savings that may be accrued to overburdened health-care systems.

Counterbalancing patient demands with evidence: results from a pan-Canadian randomized clinical trial of brief supportive-expressive group psychotherapy for women with systemic lupus erythematosus

OBJECTIVE

To evaluate the effect of Brief Supportive-Expressive Group Psychotherapy as an adjunct to standard medical care in reducing psychological distress, medical symptoms, and health care costs and improving quality of life in women with systemic lupus erythematosus (SLE).

METHODS

A randomized clinical trial was conducted with 133 SLE female patients from 9 clinics across Canada. Clinical and psychosocial measures were taken at baseline, posttreatment, and 6 and 12 months posttreatment. Outcomes assessed were psychological distress, quality of life, disease activity, health service utilization, and diminished productivity.

RESULTS

Intention-to-treat analyses revealed that there were no clinically important group differences on any of the outcome measures.

CONCLUSION

Although both groups improved over time on several measures (e.g., decreases in psychological distress, stress, and emotion-oriented coping), these changes could not be attributed to the psychotherapeutic intervention. Thus, evidence does not support the referral of these patients to this type of intervention.