Meaning-Centered Group Psychotherapy: An Effective Intervention for Improving Psychological Well-Being in Patients With Advanced Cancer
Open accessAbstract
Purpose: To test the efficacy of meaning-centered group psychotherapy (MCGP) to reduce psychological distress and improve spiritual well-being in patients with advanced or terminal cancer. Patients and Methods: Patients with advanced cancer (N = 253) were randomly assigned to manualized eight-session interventions of either MCGP or supportive group psychotherapy (SGP). Patients were assessed before and after completing the treatment and 2 months after treatment. The primary outcome measures were spiritual well-being and overall quality of life, with secondary outcome measures assessing depression, hopelessness, desire for hastened death, anxiety, and physical symptom distress. Results: Hierarchical linear models that included a priori covariates and only participants who attended ≥ three sessions indicated a significant group × time interaction for most outcome variables. Specifically, patients receiving MCGP showed significantly greater improvement in spiritual well-being and quality of life and significantly greater reductions in depression, hopelessness, desire for hastened death, and physical symptom distress compared with those receiving SGP. No group differences were observed for changes in anxiety. Analyses that included all patients, regardless of whether they attended any treatment sessions (ie, intent-to-treat analyses), and no covariates still showed significant treatment effects (ie, greater benefit for patients receiving MCGP v SGP) for quality of life, depression, and hopelessness but not for other outcome variables. Conclusion: This large randomized controlled study provides strong support for the efficacy of MCGP as a treatment for psychological and existential or spiritual distress in patients with advanced cancer.
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Supportive psychological therapy has a positive effect on anticancer treatment and prognosis of cancer patients.
“A large amount of clinical evidence shows that supportive psychological therapy has a positive effect on anticancer treatment and prognosis of cancer patients (68, 69).”
From Chronic Stress Promotes Cancer Development (2020) · cites this paper as [69]
The intervention is a novel combination of traditional behavioral symptom coping strategies, home-based physical activity, strategies from contemporary cognitive-behavioral theory-based approaches like ACT and those to foster self-compassion, concepts from MCP, and strategies to improve communication and healthcare engagement.
“The intervention, developed with input from YA cancer survivors and oncology providers, is a novel combination of traditional behavioral symptom coping strategies, home-based physical activity, strategies from contemporary cognitive-behavioral theory-based approaches like ACT [34] and those to foster self-compassion, concepts from MCP [38–41], and strategies to improve communication and healthcare”
From Improving symptom management for survivors of young adult cancer: rationale and study protocol for a pilot randomized controlled trial (2024) · cites this paper as [38]
None of the notable meaning-focused interventions for metastatic cancer patients directly target avoidance of internal experience.
“Though notable meaning-focused interventions for metastatic cancer patients exist (e.g., [14, 15]), none directly target avoidance of internal experience [25]”
Group programs are more efficient but require standard, less personalized intervention content across diverse participants.
“or group programs that are more efficient but require standard, less personalized intervention content across diverse participants [39]”
Many palliative care interventions address a single dimension of palliative care or focus on patients in general rather than anxious and depressed patients most in need of support.
“Many palliative care interventions address a single dimension of palliative care – e.g., ACP directive completion or sense of life meaning – or focus on patients in general rather than the anxious and depressed patients most in need of support [5, 13–15].”
In a study of 253 people with advanced cancer randomized to an eight-session group meaning-centered therapy program, there was significantly greater improvement in spiritual well-being, QL, depression, hopelessness, desire for hastened death, and physical symptom distress compared to those randomized to a support group.
“For example, 253 people with advanced cancer randomized to an eight-session group meaningcentered therapy program showed significantly greater improvement in spiritual well-being, QL, depression, hopelessness, desire for hastened death, and physical symptom distress compared to those randomized to a support group (Breitbart et al. 2015).”
From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Breitbart et al. 2015
Large RCTs of both group and individual meaning-centered psychotherapy have shown that these programs improve spiritual well-being and QL and significantly reduce depression, hopelessness, desire for hastened death, and physical symptom distress.
“Large RCTs of both group and individual meaning-centered psychotherapy have shown that these programs improve spiritual well-being and QL and significantly reduce depression, hopelessness, desire for hastened death, and physical symptom distress (Breitbart et al. 2015(Breitbart et al. , 2018)).”
From Psychosocial and Integrative Oncology: Interventions Across the Disease Trajectory. (2023) · cites this paper as Breitbart et al. 2015
Few demoralization-focused psychotherapies have demonstrated efficacy compared to an active control condition, and effect sizes have been modest.
“Demoralization-focused psychotherapies are available, but few have demonstrated efficacy when compared to an active control condition, and effect sizes have been modest [7–9].”
From Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: an open-label safety and feasibility pilot study. (2020) · cites this paper as [8]
The results compare favorably to a large (N = 253) trial of brief non-psychedelic meaning-centered group psychotherapy for advanced cancer patients, which found within-group Cohen's d = 0·54 for spiritual well-being, d = 0·53 for hopelessness, and d = 0·67 for depression.
“Finally, our results compare favorably to those of a large (N = 253) trial of a brief (8-week), non-psychedelic, meaning-centered group psychotherapy for advanced cancer patients, which found a within-group Cohen's d = 0·54 for spiritual well-being, d = 0·53 for hopelessness, and d = 0·67 for depression [8].”
From Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: an open-label safety and feasibility pilot study. (2020) · cites this paper as [8]
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- Authors
- Breitbart, W., Rosenfeld, B., Pessin, H., Applebaum, A., Kulikowski, J., & Lichtenthal, W. G.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2015-03-01
- Volume
- 33
- Issue
- 7
- Pages
- 749-754
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC4334778
- OpenAlex
- W2166928505
- Cited by
- 563
- References
- 41
- Citations by year
- 2026: 54 · 2025: 54 · 2024: 48 · 2023: 43 · 2022: 50 · 2021: 49 · 2020: 65 · 2019: 46 · 2018: 49 · 2017: 51 · 2016: 35 · 2015: 17 · 2013: 1
- FWCI
- 62.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- McGill University
- National Cancer Institute (R01CA128187, K07CA172216, CA128187, P30CA008748)
- Topics
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- advanced cancer, terminal cancer, spiritual well-being, psychological distress, quality of life, depression, hopelessness, physical symptom distress, existential suffering, psychological well-being
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety, Depression, Female, Humans, Male, Middle Aged, Neoplasms, Outpatients, Psychotherapy, Group, Quality of Life, Stress, Psychological, Treatment Outcome, Spirituality, Hope
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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