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Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial
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BACKGROUND: The aim of this study was to assess the efficacy of meaning-centered group psychotherapy for cancer survivors (MCGP-CS) to improve personal meaning, compared with supportive group psychotherapy (SGP) and care as usual (CAU). METHOD: A total of 170 cancer survivors were randomly assigned to one of the three study arms: MCGP-CS (n = 57); SGP (n = 56); CAU (n = 57). The primary outcome measure was the Personal Meaning Profile (PMP; total score). Secondary outcome measures were subscales of the PMP, psychological well-being (Scales of Psychological Well-being; SPWB), post-traumatic growth (Posttraumatic Growth Inventory), Mental Adjustment to Cancer (MAC), optimism (Life Orientation Test-Revised), hopelessness (Beck's Hopelessness Scale), psychological distress (anxiety and depression, Hospital Anxiety and Depression Scale; HADS) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; EORTC QLQ-C30). Outcome measures were assessed before randomization, post-intervention, and after 3 and 6 months of follow-up (FU). RESULTS: Linear mixed model analyses (intention-to-treat) showed significant differences between MCGP-CS, SGP and CAU on the total PMP score, and on (sub)scales of the PMP, SPWB, MAC and HADS. Post-hoc analyses showed significantly stronger treatment effects of MCGP-CS compared with CAU on personal meaning (d = 0.81), goal-orientedness (d = 1.07), positive relations (d = 0.59), purpose in life (d = 0.69); fighting spirit (d = 0.61) (post-intervention) and helpless/hopeless (d = -0.87) (3 months FU); and distress (d = -0.6) and depression (d = -0.38) (6 months FU). Significantly stronger effects of MCGP-CS compared with SGP were found on personal growth (d = 0.57) (3 months FU) and environmental mastery (d = 0.66) (6 months FU). CONCLUSIONS: MCGP-CS is an effective intervention for cancer survivors to improve personal meaning, psychological well-being and mental adjustment to cancer in the short term, and to reduce psychological distress in the long run.
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“MCP was more effective in improving goal-orientedness and a fighting spirit compared to the Supportive Group, as well as personal growth and environmental mastery at the 6-month follow-up.”
From Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial (2022) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Finally, we have considered possible sample loss during the treatment program, and based on studies of interventions with MCP, we expect a 30% dropout rate (9). Therefore, taking this outcome into account, our study requires a total sample size of 118 participants (59 participants per experimental condition).”
From Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial (2022) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The results at the 6-month follow-up showed that the MCP treatment improved personal meaning, positive relations, purpose in life, a fighting spirit, hopelessness, goal-orientedness, and psychological wellbeing and adjustment, and it reduced psychological distress and depressive symptoms more than the TAU condition.”
From Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial (2022) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Treatment efficacy studies have found a dropout rate of 30% (9), which can interfere with the development of the study as well as the type of statistical analysis that we can perform.”
From Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial (2022) · cites this paper as [9]
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“Therefore, previous studies suggest that intervening in meaning in life in cancer patients can be an effective treatment to improve the aforementioned negative emotional states and lead to better coping with life after a cancer diagnosis (8, 9).”
From Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial (2022) · cites this paper as [9]
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“Additional variants of MCP were also developed for various populations and settings, including: grief(14), breast cancer survivors(15), cancer caregivers(16), cancer survivors(17), and adolescents and young adult(18).”
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InfluentialMeaning-centered group psychotherapy in Portuguese cancer patients: A pilot exploratory trial
da Ponte, G., Ouakinin, S., Santo, J. E., Ohunakin, A., Prata, D., Amorim, I., Gameiro, Z., dos Santos, E. S., & BREITBART, W. S. (2021) · Palliative & Supportive Care · doi:10.1017/s1478951521000602 · Cited by 12
“…(respectively); similarly to the original version, and because of its importance described in previous studies, “Historical Sources of Meaning” occupied an entire session (Breitbart et al., 2010, 2012, 2015, 2018; Van der Spek et al., 2014, 2016; Lichtenthal et al., 2015; Rosenfeld et al., 2017).”
Meaning-Centered Psychotherapy
BREITBART, W. S., Lichtenthal, W. G., & Applebaum, A. J. (2022) · Springer eBooks · doi:10.1007/978-3-030-85702-8_23 · Cited by 9
Verdam, M. G. E., van Ballegooijen, W., Holtmaat, K., Knoop, H., Lancee, J., Oort, F. J., Riper, H. M., van Straten, A., Leeuw, I. M. V., de Wit, M., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0252035 · Cited by 9
“The selected sample consisted of data from RCTs on guided internet delivered cognitive behavioural treatment (CBT) for insomnia in the general population with [14] and without [15] elevated depressive symptoms, an RCT on meaning-centered group psychotherapy targeting personal meaning for cancer survivors [16], and fro…”
BackgroundMethodMeaninglessness, Depression and Suicidality: A Review of the Evidence
Allen, A. R. (2022) · Springer eBooks · doi:10.1007/978-3-031-06932-1_16 · Cited by 8
Aydın, R., & Kabukçuoğlu, K. (2023) · Women & Health · doi:10.1080/03630242.2023.2249123 · Cited by 8
Marco, J. H., Llombart, P., Guillén, V., Baños, R. M., Romero, R., Garcia-Conde, A., & Pérez Rodríguez, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.892573 · Cited by 7
“Treatment efficacy studies have found a dropout rate of 30% (9), which can interfere with the development of the study as well as the type of statistical analysis that we can perform.”
BackgroundMethodInfluentialPsychological Support for Cancer Patients
Khalid, S., Abbas, I., & Javed, S. (2023) · Cancer treatment and research · doi:10.1007/978-3-031-27156-4_13 · Cited by 9
The Psychological Adaptation Process in Chinese Parent Caregivers of Pediatric Leukemia Patients
Wang, M.-J., Chang, M.-Y., Cheng, M.-Y., & Zhang, R.-X. (2021) · Cancer Nursing · doi:10.1097/ncc.0000000000001034 · Cited by 7
Kita, S., Zonp, Z., & Arnault, D. S. (2022) · Journal of Advanced Nursing · doi:10.1111/jan.15331 · Cited by 7
Chu, H. S., Tak, Y. R., & Kim, S. H. (2018) · Journal of Korean Academy of Nursing · doi:10.4040/jkan.2018.48.4.454 · Cited by 7
“최근 의미중심 대처를 기반으로 한 중재프로그램은 암이나 치매와 같은 만성질환의 가족 돌봄제공자의 정신건강에 긍정적 효과를 보이는 것 으로 보고되고 있다[28,29].”
Wang, S., Zheng, M., Zhu, Y., Zhang, L., Li, X., & Wan, H. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1264257 · Cited by 7
da Ponte, G., Ouakinin, S., Santo, J. E., Amorim, I., Gameiro, Z., Fitz-Henley, M., & BREITBART, W. S. (2020) · Palliative & Supportive Care · doi:10.1017/s147895151900110x · Cited by 6
Hamilton, J. B., & Fluker, W. E. (2021) · Journal of Religion and Health · doi:10.1007/s10943-021-01215-8 · Cited by 6
Schutzeichel, F., Rot, M. A. H., van Doornik, S. F. W., Glashouwer, K. A., Frey, M. I., & de Jong, P. J. (2025) · European Eating Disorders Review · doi:10.1002/erv.3175 · Cited by 5
“Van Doornik and colleagues (2024) adapted existing manuals of meaning‐centered psychotherapies (Breitbart et al. 2018; van der Spek et al. 2017) by (i) reducing the number of sessions, and (ii) updating the content to suit the target demographic of young women with weight and shape concerns.”
Mármol-Pérez, A., Gracia‐Marco, L., Clavero‐Jimeno, A., Amaro‐Gahete, F. J., Ruiz, J. R., & Carneiro‐Barrera, A. (2025) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2025.101954 · Cited by 5
Yang, Q., Yang, J., Xiang, X., Zhao, Y., Sun, X., Yu, X., Jiang, N., Wang, Y., Ran, H., & Huang, Q. (2024) · Health and Quality of Life Outcomes · doi:10.1186/s12955-024-02283-6 · Cited by 5
“…exemplified by However, we also retrieved a study on resilience-pro-moting interventions with a non-significant effect on improving quality of life [37], which suggests that a one-size-fits-all approach to intervention is likely ineffective since the mediating effect of resilience could vary…”
BackgroundCurrin-McCulloch, J. A., Peterson, D., Kaushik, S. B., & Borrego, J. (2023) · Social Work With Groups · doi:10.1080/01609513.2023.2212391 · Cited by 5
“The intervention draws on the therapeutic factors of group work and topics center on clarifying purpose and spiritual well-being to foster hope and meaning (van der Spek et al., 2017).”
BackgroundAdapting meaning-centered psychotherapy for World Trade Center responders
Duva, M. M., Haugen, P. T., Werth, A. S., Foster, A., Chassman, E., Roberts, K. E., DePierro, J. M., Morales-Miller, M., Lowe, S. M., Pessin, H., et al. (2020) · Palliative & Supportive Care · doi:10.1017/s1478951520000061 · Cited by 5
de Diego‐Cordero, R., Gil, M. A., & Suárez-Reina, P. (2025) · Journal of Religion and Health · doi:10.1007/s10943-025-02525-x · Cited by 4
“Most articles reported statistically significant results, except for the studies by Murdoch et al., 2019; Silverman, 2016; van der Spek et al., 2017; Wright et al., 2022 which showed no effect on hope until some time after the intervention or did not show significant variations in this variable.”
A scoping review of psychosocial oncology interventions promoting posttraumatic growth
Wong, K. L., McClure, K. S., & Psillos, D. E. (2022) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000071 · Cited by 5
Rassoulian, A., & Löffler‐Stastka, H. (2022) · Psychiatria Danubina · doi:10.24869/psyd.2022.398 · Cited by 5
Yager, J., & Kay, J. (2023) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001657 · Cited by 6
Advances in the Understanding of Demoralization in Oncology and Palliative Care
Grass, L., & de Figueiredo, J. M. (2018) · Psycho-Oncologie · doi:10.3166/pson-2018-0049 · Cited by 4
Tantam, D., & van Deurzen, E. (2019) · doi:10.1002/9781119167198.ch27 · Cited by 4
Embrace subjectivity: existentially-informed clinical psychological science, practice, and teaching
Pashak, T. J., Nelson, O. M., Tunstull, M. D., Vanderstelt, B. H., Nichols, D. P., & Hitt, J. M. (2023) · Clinical Psychologist · doi:10.1080/13284207.2022.2108695 · Cited by 3
Aiello-Puchol, A., & García‐Alandete, J. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-09519-1 · Cited by 3
Wong, K. S. S., Ho, M., Hou, T., & Lin, C. (2025) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2025.08.014 · Cited by 3
The Reakiro Care Model for Persons With a Chronic Death Wish: An Epidemiological Study
Vanhie, T., Verdegem, S., Cuypers, A., Bemelmans, L., Onghena, P., & Vandenberghe, J. U. (2025) · Journal of Humanistic Psychology · doi:10.1177/00221678241313088 · Cited by 4
Grossman, M. (2022) · Springer eBooks · doi:10.1007/978-3-031-06101-1_10 · Cited by 3
Purpose in Life and Its Association to Parkinsonism
Koga, H. K., Grodstein, F., Williams, D. R., Buchman, A. S., & Kubzansky, L. D. (2024) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbae026 · Cited by 3
Wang, S., Xu, W., Zhu, Y., Zheng, M., & Wan, H. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-082092 · Cited by 2
Holtmaat, K., van der Spek, N., Rijnhart, J. J. M., Lissenberg-Witte, B. I., BREITBART, W. S., Cuijpers, P. J., & Leeuw, I. M. V. (2024) · Supportive Care in Cancer · doi:10.1007/s00520-024-09039-4 · Cited by 2
“The reduction in depressive symptoms 6 months after MCGP-CS [3] cannot be explained by enhanced meaning and should be confirmed in a future study.”
InfluentialMeaning and Psychedelics in Palliative Care: A Narrative Review
Alexander, W. B., Hansen, E., Anderson, B. T., Zarrabi, A. J., Rogers, A. H., Loewen, G., Ficcaro, Z. R., Alexander, M. H., Schaefer, D., & Case, A. A. (2025) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2025.10.015 · Cited by 3
Chu, Q., Sun, F., Zhu, X., Xia, H., Bian, D., He, G., Yang, J., Zhang, P., & He, Y. (2025) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2025.100549 · Cited by 2
“Similarly, in a randomized controlled trial involving cancer patients who had completed primary treatment, van der Spek et al. (2017) found that meaning-centered group psychotherapy — focused on deriving meaning from the cancer experience — was associated with greater reductions in depression…”
Meaning-Centered Psychotherapy
Applebaum, A. J., Lichtenthal, W. G., Pessin, H., & BREITBART, W. S. (2022) · Oxford University Press eBooks · doi:10.1093/med/9780197583838.003.0035 · Cited by 2
Metadata
- Authors
- van der Spek, N., Vos, J., van Uden-Kraan, C. F., Breitbart, W., Cuijpers, P., Holtmaat, K., Witte, B. I., Tollenaar, R. A. E. M., & Verdonck-de Leeuw, I. M.
- Affiliations
- University of Roehampton (GB)
- Memorial Sloan Kettering Cancer Center (US)
- Vrije Universiteit Amsterdam (NL)
- Leiden University Medical Center (NL)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-04-04
- Volume
- 47
- Issue
- 11
- Pages
- 1990-2001
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC5501751
- OpenAlex
- W2604525151
- Cited by
- 135
- References
- 42
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 17 · 2023: 19 · 2022: 28 · 2021: 14 · 2020: 11 · 2019: 9 · 2018: 13 · 2017: 3
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- green
- research.vu.nl
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institutes of Health (R41TR003571)
- National Cancer Institute (P30CA008748)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- cancer survivors, personal meaning, psychological well-being, mental adjustment to cancer, psychological distress, posttraumatic growth, hopelessness, quality of life
- MeSH terms
- Optimism, Cancer Survivors, Adult, Aged, Anxiety, Depression, Female, Humans, Male, Middle Aged, Personal Satisfaction, Psychotherapy, Group, Quality of Life, Outcome Assessment, Health Care, Hope
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