Group support for patients with metastatic cancer. A randomized outcome study.
01 May 1981-Archives of General Psychiatry (American Medical Association)-Vol. 38, Iss: 5, pp 527-533
TL;DR: Objective evidence is provided that a supportive group intervention for patients with metastatic cancer results in psychological benefit and mechanisms underlying the effectiveness of this group intervention are explored.
Abstract: • The effects of weekly supportive group meetings for women with metastatic carcinoma of the breast were systematically evaluated in a one-year, randomized, prospective outcome study. The groups focused on the problems of terminal illness, including improving relationships with family, friends, and physicians and living as fully as possible in the face of death. We hypothesized that this intervention would lead to improved mood, coping strategies, and self-esteem among those in the treatment group. Eighty-six patients were tested at four-month intervals. The treatment group had significantly lower mooddisturbance scores on the Profile of Mood States scale, had fewer maladaptive coping responses, and were less phobic than the control group. This study provides objective evidence that a supportive group intervention for patients with metastatic cancer results in psychological benefit. Mechanisms underlying the effectiveness of this group intervention are explored.
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TL;DR: In this paper, the authors present a model that provides a conceptual framework for assessing the client's resources as he or she attempts to address the psychosocial issues that may occur as a result of this disease.
Abstract: The emerging empirical and clinical literature on the psychosocial issues of human immunodeficiency virus (HIV) has only begun to guide clinicians in their work with seropositive clients. This article presents a model that provides a conceptual framework for assessing the client's resources as he or she attempts to address the psychosocial issues that may occur as a result of this disease. The model has four components: special characteristics, social supports, situation, and client characteristics. It is hypothesized that these client resources predict or moderate the clients response to HIV infection. Responses to HIV infection are discussed followed by counseling strategies and interventions to address each response or reaction. Case management issues are presented including ethical dilemmas, rethinking clinical goals, the changing boundaries of the therapeutic relationship, transference, and countertransference.
55 citations
TL;DR: Group psychotherapy is one of the most widely practised treatment methods in psychiatry, with an extensive literature, but it has long been regarded as the poor relation to individual therapy.
Abstract: Group psychotherapy is one of the most widely practised treatment methods in psychiatry, with an extensive literature, but it has long been regarded as the poor relation to individual therapy. Nineteenth-century ideas about the primacy of the individual, taken up by psychoanalysis, continue to
55 citations
TL;DR: The primary finding was that women from the low avoidance coping cluster were significantly better adjusted than women from any of the remaining clusters.
Abstract: The aim of this study was to generate distinct clusters of women with breast cancer, and to evaluate differences between clusters with respect to decisional control, psychological adjustment, and frustration expression. Thirty‐seven Stage I and 33 Stage II newly diagnosed breast cancer patients from two medical oncology clinics participated. A cluster analysis of the coping data produced three distinct patient clusters. The primary finding was that women from the low avoidance coping cluster were significantly better adjusted than women from the remaining clusters. Women from the low avoidance coping cluster also preferred more active involvement in treatment decision‐making. Further research is needed to prospectively detail the mechanisms by which cognitive avoidance hampers psychological adjustment to cancer.
55 citations
TL;DR: In this paper, the authors investigated the psychophysiological outcomes of different psychosocial interventions for breast cancer patients and found that BMS intervention produced the greatest and the most sustained effects.
Abstract: This study aimed to investigate the psychophysiological outcomes of different psychosocial interventions for breast cancer patients. Participants were randomly assigned into 3 intervention groups, namely, Body-Mind-Spirit (BMS), Supportive-Expressive (SE), and Social Support Self-Help (SS) groups; a no-intervention group was used as control. Salivary cortisol was used as the physiological stress marker. Distress level, mental adjustment, emotional control, and social support were measured. Data were collected at baseline, 4 month, and 8 month. Preliminary results indicated that BMS intervention produced the greatest and the most sustained effects. It enhanced positive social support, reduced psychological distress, emotional control, and negative mental adjustment. Total salivary cortisol was lowered after 8 months. Most participants in SE groups indicated the treatment helpful, but changes in psychophysiological outcomes were not statistically significant. Participants in SS groups seemed less likely to benefit from the intervention. The no intervention control group indicated a reduction in social support. These outcomes suggest that active professional intervention is more likely to yield therapeutic effects. In particular, psychosocial intervention attending to the spiritual dimension contributes to positive outcomes.
55 citations
TL;DR: This article examined social comparisons made by women with breast cancer who participated in peer-support interventions and found that negative comparisons were associated with a decrease in perceived control and an increase in uncertainty over time.
Abstract: We examined social comparisons made by women with breast cancer who participated in peer-support interventions. This setting. in which participants were exposed to similar others, allowed for a longitudinal investigation of the frequency, antecedents. and consequences of social comparison. Consistent with the literature, the majority of comparisons were made to worse-off others (downward), and the majority of comparisons were associated with positive affect (positive comparisons). Low self-esteem. low internal locus of control, and high illness uncertainty were associated with making more negative comparisons. In addition, negative comparisons were associated with a decrease in perceived control and an increase in uncertainty over time. whereas positive doanbard comparisons were associated with an increase in self-esteem. Implications for support groups are discussed.
54 citations
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TL;DR: In this paper, the effects of reward or reinforcement on preceding behavior depend in part on whether the person perceives the reward as contingent on his own behavior or independent of it, and individuals may also differ in generalized expectancies for internal versus external control of reinforcement.
Abstract: The effects of reward or reinforcement on preceding behavior depend in part on whether the person perceives the reward as contingent on his own behavior or independent of it. Acquisition and performance differ in situations perceived as determined by skill versus chance. Persons may also differ in generalized expectancies for internal versus external control of reinforcement. This report summarizes several experiments which define group differences in behavior when Ss perceive reinforcement as contingent on their behavior versus chance or experimenter control. The report also describes the development of tests of individual differences in a generalized belief in internal-external control and provides reliability, discriminant validity and normative data for 1 test, along with a description of the results of several studies of construct validity.
21,451 citations
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01 Jan 1969
TL;DR: In this article, the implications of terminal illness for patients and for those involved in their care were discussed, and patients invited to talk about their experience found great relief in expressing their fear and anger and were able to move towards a state of acceptance and peace.
Abstract: Although most areas of human experience are nowadays discussed freely and openly, the subject of death is still surrounded by conventional attitudes and reticence that offer only fragile comfort because they evade the real issues. The dying may thus be denied the opportunity of sharing their feelings and discussing their needs with family, friends, or hospital staff. Although receiving devoted medical care, a dying patient is often socially isolated and avoided, since professional staff and students can find contact painful and embarrasing.
Aware of the strains imposed on all sides by this situation, Dr Kubler-Ross established a seminar at the University of Chicago to consider the implications of terminal illness for patients and for those involved in their care. Patients invited to talk about their experience often found great relief in expressing their fear and anger and were able to move towards a state of acceptance and peace. The seminar, initially composed of students of medicine, sociology, psychology, and theology, but later joined by hospital staff and relatives of patients, enabled many members to come to terms with their own feelings and to respond constructi to what the patients had to teach them.
5,220 citations
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TL;DR: A study of 800 outpatient visits to Children's Hospital of Los Angeles as discussed by the authors explored the effect of verbal interaction between doctor and patient on patient satisfaction and follow-through on follow-up.
Abstract: Study of 800 outpatient visits to Childrens Hospital of Los Angeles to explore the effect of the verbal interaction between doctor and patient on patient satisfaction and follow-through on...
947 citations