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In Goodwin’s recent study of supportive–expressive group therapy for metastatic patients, she and her colleagues found that group therapy benefited women who were more distressed at baseline but that it did not benefit women who were less distressed at that time.
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To our knowledge there has been limited research addressing this question. While the prognosis for primary breast cancer patients is significantly better than it is for metastatic breast cancer patients, a diagnosis of primary breast cancer nevertheless activates existential concerns about isolation, death, one’s identity, and life’s meaning and examining these concerns in a supportive environment may be beneficial.Ī second aim was to examine who was most likely to benefit from the intervention. Our first aim was to test the efficacy of this intervention for reducing mood disturbance for women who received the intervention compared with a control group. Indeed, some might question whether primary breast cancer patients would benefit from an intervention that emphasizes examining existential concerns as opposed to an emphasis on putting the cancer behind them. This intervention, which encourages building social support, emotional expression and the examination of existential concerns, has been shown to reduce mood disturbance and trauma symptoms and improve coping in metastatic breast cancer patients, but, except for a feasibility study conducted in preparation for this randomized trial, it has not been tested in women with primary breast cancer. To conduct this study of group therapy for primary breast cancer patients, we developed a brief version of the supportive–expressive model. The aim of the present study was to test the supportive–expressive group therapy model in community oncology practices utilizing personnel already working with these populations. To our knowledge, there are few group therapy studies for cancer survivors that have included multiple sites, and fewer still that considered the impact of site or group composition.
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In this study, we were interested in demonstrating the benefits of a brief supportive–expressive group therapy as well as whether this intervention could be transferred to community oncology settings. However, it has been suggested and demonstrated that the quality of the facilitation of the unstructured groups may be a critical factor influencing outcome. By pitting a structured psychoeducation group against an unstructured peer support group, the psychoeducation group was found to be more effective. The interventions in these investigations have ranged from unstructured to structured approaches, with results showing benefits for both structured and unstructured groups. There has been considerable research on group therapy for cancer patients over the last 20 years, and in recent years a number of studies have examined the benefits of group interventions for early stage breast cancer. There is evidence that primary breast cancer patients continue to be vulnerable to psychological distress for many years. Although psychological distress among cancer patients often abates with time, as many as 22–43% have been shown to meet criteria for a psychiatric disorder six months later. Several recent studies of women newly diagnosed with early stage breast cancer have found high levels of psychiatric morbidity, particularly anxiety and affective disorders. Breast cancer patients often experience significant psychological distress after diagnosis and during initial treatment.