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

  • William Breitbart
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Shannon Poppito
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Barry Rosenfeld
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Andrew J. Vickers
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Yuelin Li
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Jennifer Abbey
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Megan Olden
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Hayley Pessin
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Wendy Lichtenthal
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Daniel Sjoberg
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.
  • Barrie R. Cassileth
    William Breitbart, Andrew J. Vickers, Yuelin Li, Hayley Pessin, Wendy Lichtenthal, Daniel Sjoberg, and Barrie R. Cassileth, Memorial Sloan-Kettering Cancer Center; Megan Olden, Weill-Cornell Medical College of Cornell University, New York; Barry Rosenfeld, Fordham University, Bronx, NY; Shannon Poppito, Memorial Sloan-Kettering Cancer Center, New York, NY; and Jennifer Abbey, Independent Practice,Montclair, NJ.

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<jats:sec><jats:title>Purpose</jats:title><jats:p> 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. </jats:p></jats:sec><jats:sec><jats:title>Patients and Methods</jats:title><jats:p> 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. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> 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. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> 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. </jats:p></jats:sec>

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