Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-17T18:22:29.128Z Has data issue: false hasContentIssue false
  • English
  • Français

Experience of application of the meaning-centered psychotherapy to Japanese bereaved family of patients with cancer – A mixed-method study

Published online by Cambridge University Press:  09 December 2022

Rumiko Koda Open the ORCID record for Rumiko Koda [Opens in a new window] ,
Daisuke Fujisawa ,
Mayu Kawaguchi  and
Hitoshi Kasai
Rumiko Koda*
Affiliation:
College of Humanities and Social Sciences Academic Institute, Shizuoka University, Shizuoka, Shizuoka, Japan
Daisuke Fujisawa
Affiliation:
Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
Mayu Kawaguchi
Affiliation:
Rehabilitation Department, Shonan Keiiku Hospital, Fujisawa, Kanagawa, Japan
Hitoshi Kasai
Affiliation:
College of Humanities and Social Sciences Academic Institute, Shizuoka University, Shizuoka, Shizuoka, Japan
*
Author for correspondence: Rumiko Koda, College of Humanities and Social Sciences Academic Institute, Shizuoka University, 836 Ohya Suruga-ku, Shizuoka 422-8529, Japan. Email: kohda.rumiko@shizuoka.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

This study aimed to adapt the meaning-centered psychotherapy (MCP) to treat post-bereavement grief in Japanese bereaved families who lost their loved ones to cancer and to examine the feasibility of the intervention using both quantitative and qualitative methods.

Methods

A modified version of MCP was developed with cultural consideration. Bereaved individuals aged ≥18 years who had lost their family members to cancer at least 6 months before and had severe or persistent grief with a score of ≥26 on the Inventory of Complicated Grief (ICG-19) were included in the study. The participants received the modified version of MCP, which was provided in a 5-session monthly format. The levels of grief (ICG-19), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), general health (General Health Questionnaire-12), and post-traumatic growth (Post-traumatic Growth Inventory -Short Form) were compared before and after the intervention.

Results

Five bereaved individuals were enrolled, and all the participants completed the program. The mean scores of the ICG-19. The participants’ sense of regret, guilt, and being separated from the deceased person gradually shifted to the reappraisal of the experience, leading to a broadened view of the relationship with the deceased, and rediscovery of the core values, identity, and roles of the participants through the process of rediscovery of the meaning of life.

Significance of results

A modified version of the MCP was well accepted by Japanese bereaved families. The intervention appears to promote the rediscovery of the meaning of life and appears to have the potential to alleviate the bereaved individuals’ depression and grief-related symptoms and to facilitate their post-traumatic growth.

Keywords

BereavementBrief psychotherapyDepressionMeaningProlonged grief
Type
Original Article
Information
Palliative & Supportive Care , Volume 21 , Issue 4 , August 2023 , pp. 594 - 602
Check for updates
Copyright
© The Author(s), 2022. Published by Cambridge University Press.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ando, M, Ninosaka, Y, Okamura, K, et al. (2015) Difficulties in caring for a patient with cancer at the end of life at home and complicated grief. American Journal of Hospice and Palliative Medicine 32, 173–177. doi:10.1177/1049909113514626CrossRefGoogle ScholarPubMed
Aoyama, M, Sakaguchi, Y, Fujisawa, D, et al. (2020) Insomnia and changes in alcohol consumption: Relation between possible complicated grief and depression among bereaved family caregivers. Journal of Affective Disorders 275, 1–6. doi:10.1016/j.jad.2020.06.023CrossRefGoogle ScholarPubMed
Aoyama, M, Sakaguchi, Y, Morita, T, et al. (2018) Factors associated with possible complicated grief and major depressive disorders. Psycho-Oncology 27, 915–921. doi:10.1002/pon.4610CrossRefGoogle ScholarPubMed
Applebaum, A, Kulikowski, JR and Brietbart, W (2015) Meaning-centered psychotherapy for caregivers (MCP-C): Rationale and overview. Palliative & Supportive Care 13, 1631–1641. doi:10.1017/S1478951515000450CrossRefGoogle ScholarPubMed
Barrera, M, O’Connor, K, D’Agostino, NM, et al. (2009) Early parental adjustment and bereavement after childhood cancer death. Death Studies 33, 497–520. doi:10.1080/07481180902961153CrossRefGoogle ScholarPubMed
Boelen, PA and Prigerson, HG (2007) The influence of symptoms of prolonged grief disorder, depression, and anxiety on quality of life among bereaved adults: A prospective study. European Archives of Psychiatry and Clinical Neuroscience 257, 444–452. doi:10.1007/s00406-007-0744-0CrossRefGoogle ScholarPubMed
Breitbart, W and Poppito, SR (2014) Individual Meaning-centered Psychotherapy for Patients with Advanced Cancer: A Treatment Manual. Oxford: Oxford University Press.10.1093/med/9780199837243.001.0001CrossRefGoogle Scholar
Brietbart, W, Pessin, H, Rosenfeld, B, et al. (2018) Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer. Cancer 124, 3231–3239. doi:10.1002/cncr.31539CrossRefGoogle Scholar
Brietbart, W, Poppito, S, Rosenfeld, B, et al. (2012) Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. Journal of Clinical Oncology 30, 1304–1309. doi:10.1200/JCO.2011.36.2517CrossRefGoogle Scholar
Brietbart, 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, 21–28. doi:10.1002/pon.1556CrossRefGoogle Scholar
Brietbart, W, Rosenfeld, B, Pessin, H, et al. (2015) Meaning-centered group psychotherapy: An effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology 33, 749–754. doi:10.1200/JCO.2014.57.2198CrossRefGoogle Scholar
Bryant, RA, Kenny, L, Joscelyne, A, et al. (2014) Treating prolonged grief disorder: A randomized clinical trial. JAMA Psychiatry 71, 1332–1339. doi:10.1001/jamapsychiatry.2014.1600CrossRefGoogle ScholarPubMed
Cann, A, Calhoun, LG, Tedeschi, RG, et al. (2010) Short form of the posttraumatic growth inventory. Anxiety, Stress, and Coping 23, 127–137. doi:10.1080/10615800903094273CrossRefGoogle ScholarPubMed
Frankl, VE (1959/1992) Man’s Search for Meaning, Revised edn. Boston: Beacon Press.Google Scholar
Fujisawa, D, Miyashita, M, Nakajima, S, et al. (2010) Prevalence and determinants of complicated grief in general population. Journal of Affective Disorders 127, 352–358. doi:10.1016/j.jad.2010.06.008CrossRefGoogle ScholarPubMed
Fukunishi, I (1990) The assessment of cut-off point of the general health questionnaire (GHQ) in the Japanese version. Clinical Psychology 3(3), 228–234.Google Scholar
Glaser, B and Strauss, A (1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine Publishing Company.Google Scholar
Goldberg, DP, Gater, R, Sartorius, N, et al. (1997) The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine 27, 191–197. doi:10.1017/S0033291796004242CrossRefGoogle ScholarPubMed
Hashimoto, N (2008) A review of studies on the concept of “grief” – attempts to approach human experiences of loss. Bulletin of the Graduate School of Education, The University of Tokyo, 48, 213–219.Google Scholar
Johannsen, M, Damholdt, MF, Zachariae, R, et al. (2019) Psychological interventions for grief in adults: A systematic review and meta-analysis. Randomized controlled trials. Journal of Affective Disorders 15, 69–86. doi:10.1016/j.jad.2019.04.065CrossRefGoogle Scholar
Kinoshita, Y (2016) Basic characteristics of M-GTA and its analytical process: Renewing possibilities of qualitative research. Journal of Health Care and Nursing 13(1), 1–11.Google Scholar
Klass, D, Silverman, PR and Nickman, SL (1996) Continuing Bonds: New Understandings of Grief. New York: Taylor & Francis.Google Scholar
Lichtenthal, WG, Catarozoli, C, Masterson, M, et al. (2019) An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation. Palliative & Supportive Care 17, 2–12. doi:10.1017/S1478951518000925CrossRefGoogle ScholarPubMed
Li, J, Precht, DH, Mortensen, PB, et al. (2003) Mortality in parents after death of a child in Denmark: A nationwide follow-up study. The Lancet 361, 363–367. doi:10.1016/S0140-6736(03)12387-2CrossRefGoogle Scholar
Litz, BT, Schorr, Y, Delaney, E, et al. (2014) A randomized controlled trial of an Internet-based therapist-assisted indicated preventive intervention for prolonged grief disorder. Behaviour Research and Therapy 61, 23–34. doi:10.1016/j.brat.2014.07.005CrossRefGoogle ScholarPubMed
Lundorff, M, Holmgren, H, Zachariae, R, et al. (2017) Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders 212, 138–149. doi:10.1016/j.jad.2017.01.030CrossRefGoogle ScholarPubMed
MacKinnon, CJ, Smith, NG, Henry, M, et al. (2015) Reconstructing meaning with others in loss: A feasibility pilot randomized controlled trial of a bereavement group. Death Studies 39, 411–421. doi:10.1080/07481187.2014.958628CrossRefGoogle Scholar
Nakajima, S (2012) Phenomenology and treatment of complicated grief in the bereaved of cancer patients. Journal of Stress Sciences 27, 33–42.Google Scholar
Nakajima, S, Ito, M, Ishimaru, K, et al. (2010) Prevalence and risk factors for prolonged grief disorder in adults who lost significant others. Meiji Yasuda Kokoro Health Foundation Research Grant Thesis 45, 119–126.Google Scholar
Neimeyer, RA (2000) Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies 24, 541–558. doi:10.1080/07481180050121480CrossRefGoogle ScholarPubMed
Neimeyer, RA (2001) Reauthoring life narratives: Grief therapy as meaning reconstruction. Israel Journal of Psychiatry 38, 171–183.Google ScholarPubMed
Otani, H, Yoshida, S, Mori, T, et al. (2017) Meaningful communication before death, but not present at the time of death itself, is associated with better outcomes on measures of depression and complicated grief among bereaved family members of cancer patients. Journal of Pain and Symptom Management 54, 273–279. doi:10.1016/j.jpainsymman.2017.07.010CrossRefGoogle Scholar
Ott, CH (2003) The impact of complicated grief on mental and physical health at various points in the bereavement process. Death Studies 27, 249–272. doi:10.1080/07481180302887CrossRefGoogle ScholarPubMed
Prigerson, HG, Bierhals, AJ, Kasl, SV, et al. (1997) Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry 154, 616–623.Google ScholarPubMed
Prigerson, HG, Boelen, PA, Xu, J, et al. (2021) Validation of the new DSM-5-TR criteria for prolonged grief disorder and the PG-13-Revised (PG-13-R) scale. World Psychiatry 20, 96–106. doi:10.1002/wps.20823CrossRefGoogle ScholarPubMed
Prigerson, HG, Maciejewski, PK, Raynolds, CF, et al. (1995) Inventory of complicated grief: A scale to measure maladaptive symptoms of loss. Psychiatry Research 59, 65–79. doi:10.1016/0165-1781(95)02757-2CrossRefGoogle ScholarPubMed
Radloff, LS (1977) The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1, 385–401. doi:10.1177/014662167700100306CrossRefGoogle Scholar
Rosenfeld, B, Saracino, R, Tobias, K, et al. (2017) Adapting meaning-centered psychotherapy for the palliative care setting: Results of a pilot study. Palliative Medicine 31, 140–146. doi:10.1177/0269216316651570CrossRefGoogle ScholarPubMed
Rosner, R, Pfoh, G and Kotoucova, M (2011) Treatment of complicated grief. European Journal of Psychotraumatology 2, . doi:10.3402/ejpt.v2i0.7995CrossRefGoogle ScholarPubMed
Sakaguchi, Y (2020) Introduction to Grief Studies Learning to Grieve Bereavement. Kyoto: Showaido, 158–159.Google Scholar
Sakaguchi, Y, Kashiwagi, T and Tsunefuzi, A (2001) Coping patterns after spousal loss and their association with mental health. Japanese Journal of Psychosomatic Medicine 41(6), 439–445.Google Scholar
Sakaguchi, Y, Kashiwagi, T and Tsunefuzi, A (2002) The effects of bereaved families’ emotional expression on mental health – Is emotional expression really an effective coping strategy? The Japanese Journal of Clinical Research on Death and Dying 25, 58–63.Google Scholar
Shima, S, Shikano, T, Kitamura, T, et al. (1985) New self-rating scale for depression. Clinical Psychiatry 27, 717–723.Google Scholar
Simon, NM, Shear, KM, Thompson, EH, et al. (2007) The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Comprehensive Psychiatry 48, 395–399. doi:10.1016/j.comppsych.2007.05.002CrossRefGoogle ScholarPubMed
Stroebe, M, Schut, H and Stroebe, W (2007) Health outcomes of bereavement. The Lancet 370, 1960–1973. doi:10.1016/S0140-6736(07)61816-9CrossRefGoogle ScholarPubMed
Yamamoto, J, Okonogi, K, Iwasaki, T, et al. (1969) Mourning in Japan. American Journal of Psychiatry 125, 1660–1665. doi:10.1176/ajp.125.12.1660CrossRefGoogle ScholarPubMed
Zisook, S and Shear, K (2009) Grief and bereavement: What psychiatrists need to know. World Psychiatry 8, 67–74. doi:10.1002/j.2051-5545.2009.tb00217.xCrossRefGoogle ScholarPubMed