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The advanced cancer patient experience of undertaking meaning and purpose (MaP) therapy

  • Carrie Lethborg (a1), Penelope Schofield (a2) and David Kissane (a3)

Abstract

Objective:

The objective of this study was to describe the experience of undertaking meaning and purpose (MaP) therapy for patients with advanced cancer, with an aim of refining therapeutic processes involved prior to pilot testing. Specifically, we were interested in examining the themes arising from participation in the intervention in relation to our therapeutic goals, and how acceptable both the number of sessions and processes used were.

Method:

A convenience sample of people living with advanced cancer was recruited to participate in this process, resulting in 24 therapy sessions for analysis.

Results:

A thematic analysis of each session illustrated that the process of MaP therapy is one that encourages reflection, offers insights, and can be confrontational, but can also allow participants to “shift” their perspective and focus onto meaningful goals. Results illustrate how the therapist creates a therapeutic frame that holds up a poignant portrayal of the meaning of life lived, and mirrors this to the patient, such that they grasp its rich texture. Participants' descriptions showed how they were buoyed forward as a result, with renewed vigor and enthusiasm, despite their illness and any physical restrictions that it imposed.

Significance of results:

A planned pilot test of this intervention will enable us to determine potential effect sizes of this therapy in reducing distress and increasing meaning prior to a full randomized controlled trial. Understanding the processes involved and the experiences of participation in meaning-based therapies is crucial to the future strength of this area of psychotherapy.

Copyright

Corresponding author

Address correspondence and reprint requests to: Carrie Lethborg, Oncology Department, St. Vincent's Hospital, Fitzroy, Victoria, Australia, 3104. E-mail: carrie.lethborg@svhm.org.au

References

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Antonovsky, A. (1987). Unravelling the Mystery of Health: How People Manage Stress and Stay Well. San Francesco: Jossey- Bass.
Bauer-Wu, S. & Farran, C.J. (2005). Meaning in life and psycho-spiritual functioning. Journal of Holistic Nursing, 23, 172190.
Breitbart, W., Gibson, C., Poppito, S., et al. (2004). Psychotherapeutic interventions at the end of life: A focus on meaning and spirituality. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie, 49, 366372.
Breitbart, W., Rosenfeld, B., Gibson, C., et al. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: A pilot randomized controlled trial. Psycho-oncology, 19, 2128.
Charon, R. (2004). Narrative and medicine. New England Journal of Medicine, 350, 862864.
Chochinov, H.M. (2002). Dignity-Conserving Care—A New Model for Palliative Care, Helping the Patient Feel Valued. Journal of the American Medical Association, 297(17), 22532260.
Clarke, D. (2003). Faith and hope. Australasian Psychiatry, 11, 164168.
Cole, B. & Pargament, I.K. (1999). Re-creating your life: A spiritual/psychotherapeutic intervention for people diagnosed with cancer. Psycho-oncology, 8, 395407.
Danhauer, S.C., Carlson, C.R. & Andrykowski, M.A. (2005). Positive psychosocial functioning in later life: Use of meaning-based coping strategies by nursing home residents. Journal of Applied Gerontology, 24, 299318.
Davis, C.G., Nolen-Hoeksema, S. & Larson, J. (1998). Making sense of loss and benefiting from the experience: Two construals of meaning. Journal of Personality & Social Psychology, 75, 561574.
Folkman, S. & Moskowitz, J.T. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647654.
Frankl, V. (1963). Man's Search for Meaning: An Introduction to Logotherapy. New York: Washington Square Press.
Frankl, V. (1985). Man's Search for Meaning. New York: Washington Square Press.
Gall, T.L., Guirguis-Youngerm, M., Charbonneau, C., et al. (2009). The trajectory of religious coping across time in response to the diagnosis of breast cancer. Psycho-oncology, 18, 11651178.
Goodwin, P.J., Leszcz, M., Ennis, M., et al. (2001). The effect of group psychosocial support on survival in metastatic breast cancer. New England Journal of Medicine, 345, 17191726.
Greenstein, M. & Breitbart, W. (2000). Cancer and the experience of meaning: A group psychotherapy program for people with cancer. American Journal of Psychotherapy, 54, 486500.
Herth, K. (1990). Fostering hope in terminally-ill people. Journal of Advanced Nursing, 15, 12501259.
Holland, J., Poppito, S., Nelson, C., et al. (2009). Reappraisal in the eighth life cycle stage: A theoretical psychoeducational intervention in elderly patient with cancer. Palliative & Supportive Care, 7, 271279.
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7, 113136.
Kissane, D.W., Grabsch, B., Clarke, D.M., et al. (2007). Supportive-expressive group therapy for women with metastatic breast cancer: Survival and psychosocial outcome from a randomized controlled trial. Psycho-Oncology, 16, 227286.
Lawton, J. (1998). Contemporary hospice care: The sequestration of the unbounded body and “dirty dying.” Sociology of Health and Illness, 20, 121143.
Lee, V., Cohen, S.R., Edgar, L., et al. (2004). Clarifying “meaning” in the context of cancer research: A systematic literature review. Palliative and Supportive Care, 2, 291303.
Lethborg, C., Aranda, S., Bloch, S., et al. (2006). The role of meaning in advanced cancer – Integrating the constructs of assumptive world, sense of coherence and meaning-based coping. Journal of Psychosocial Oncology, 24, 2742.
Lethborg, C., Aranda, S. & Kissane, D. (2007). To what extent does meaning mediate adaptation to cancer? — The relationship between physical suffering, meaning in life and connection to others in adjustment to cancer. Palliative and Supportive Care, 5, 377388.
Lethborg, C., Aranda, S. & Kissane, D. (2008). Meaning in adjustment to cancer: A model of care, Palliative & Supportive Care, 6, 6170.
McKnight, P.E. & Kashdan, T.B. (2009). Purpose in life as a system that creates and sustains health and well-being: An integrative, testable theory. Review of General Psychology, 13, 242251.
Meraviglia, M. (2006). Effects of spirituality in breast cancer survivors. Oncology Nursing Forum, 33, E1E7.
Mishler, E. (1986). Research Interviewing: Context and Narrative. Cambridge: Harvard University Press.
Park, C. & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1, 115144.
Patton, M.Q. (1990). Qualitative Evaluation and Research Methods. Newbury Park, CA: Sage.
Richer, M-C. & Ezer, H. (2002). Living in it, living with it and moving it on: Dimensions of meaning during chemotherapy. Oncology Nursing Forum, 29, 113119.
Soelle, D. (1975). Suffering (Kalin, E.R., Trans.). Philadelphia: Fortress Press.
Spiegel, D., Bloom, J.R., Kraemer, H.C., et al. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888891.
Spiegel, D., Butler, L., Giese-Davis, J., et al. (2007). Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer. Cancer, 110, 11301138.
Spira, J.L. (2000). Existential psychotherapy in palliative care. In Handbook of Psychiatry in Palliative Medicine. Chochinov, H. & Breitbart, W. (ed.), New York: Oxford University Press, 197213.
Vickberg, S.M., DuHamel, K.N., Smith, M.Y., et al. (2001). Global meaning and psychological adjustment among survivors of bone marrow transplant. Psycho-oncology, 10, 2939.
Viederman, M. (1983). Psychodynamic life narrative in a psychotherapeutic intervention useful in crisis situations. Psychiatry, 46, 236246.
Weber, R.P. (1990). Basic Content Analysis. Newbury Park, CA: Sage.
White, M. (1990). Narrative Means to Therapeutic Ends. New York: Norton.
White, M. (1997). Narratives of Therapists' Lives. Adelaide: Dulwich.
Yalom, I.D. (1980). Existential Psychotherapy. New York: Basic Books.

Keywords

The advanced cancer patient experience of undertaking meaning and purpose (MaP) therapy

  • Carrie Lethborg (a1), Penelope Schofield (a2) and David Kissane (a3)

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