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Process of therapeutic changes in Meaning-Centered Group Psychotherapy adapted to the Portuguese language: A narrative analysis

Published online by Cambridge University Press:  20 January 2020

Guida da Ponte Open the ORCID record for Guida da Ponte [Opens in a new window] ,
Sílvia Ouakinin ,
Jorge Espírito Santo ,
Inês Amorim ,
Zita Gameiro ,
Mindi Fitz-Henley  and
William Breitbart
Guida da Ponte*
Affiliation:
Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal Medical School of Lisbon, University of Lisbon, Lisboa, Portugal
Sílvia Ouakinin
Affiliation:
Medical School of Lisbon, University of Lisbon, Lisboa, Portugal University Clinic of Medical Psychology and Psychiatry, Medical School of Lisbon, University of Lisbon, Lisboa, Portugal
Jorge Espírito Santo
Affiliation:
Oncology Unit, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal
Inês Amorim
Affiliation:
Algarve Cancer Association, Faro, Portugal
Zita Gameiro
Affiliation:
Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Barreiro, Portugal
Mindi Fitz-Henley
Affiliation:
Department of Psychiatry, University Hospital of the West Indies, Kingston, Jamaica
William Breitbart
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
*
Author for correspondence: Guida da Ponte, Department of Psychiatry and Mental Health, Centro Hospitalar Barreiro-Montijo, EPE, Avenida Movimento das Forças Armadas, 2830-003Barreiro, Portugal. E-mail: [email protected]
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Abstract

Objective

The aim was to understand the processes of therapeutic changes in Meaning-Centered Group Psychotherapy (MCGP) in a Portuguese sample.

Method

Adult cancer patients with distress motivated to participate in MCGP were identified; descriptive and narrative analyses were performed on the session content.

Results

The sample had 24 participants (mean age: 63.43 years); the majority were females (75%), with a median academic degree (54%). Breast cancer was most frequent (67%) at the localized stage (71%). The narrative analysis defined seven categories according to the MCGP themes. In “Moments with Meaning (MwM),” the most relevant dimensions were related to interpersonal relations, the moment of diagnosis, and personal achievements. This category established relations with almost all other categories, as did the category “historical sources of meaning (SoM).” The category “identity before and after cancer diagnosis” was only related to “attitudinal SoM” and “transitions.” Historical SoM had two dimensions, “past” and “present and future” legacies, in which prominent topics related to family, childhood, achieved goals, and values to pass to others explored. Attitudinal SoM established relations only with the category “creative SoM,” in which “courage” and “responsibility” were the main dimensions, which were also related to “MwM,” “historical,” and “attitudinal SoM.” Experiential SoM, with the main dimension “love,” was related to “MwM” and “historical SoM.” Transitions only established relations with “historical SoM” and “identity before and after cancer.”

Significance of results

The findings that “MwM” and “historical SoM” were the categories which established a solid pattern of relations suggest that these are the main psychotherapy topics that can have more influence for the participants; one explanation is that these categories imply a concrete way of thinking, which is easier to understand. This process of therapeutic changes must be integrated in a cultural context, as it is well known to have an impact upon the “meaning” of life.

Keywords

AdaptationMeaning-Centered PsychotherapyNarrative analysisPortuguese languageTherapeutic changes
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 3 , June 2020 , pp. 254 - 262
Copyright
Copyright © Cambridge University Press 2020

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References

Antoni, MH, Lehman, JM, Kilbourn, KM, et al. (2001) Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology 20(1), 20–32.CrossRefGoogle ScholarPubMed
Applebaum, AJ, Kulikowski, JR and Breitbart, W (2015) Meaning-centered psychotherapy for cancer caregivers (MCP-C): Rationale and overview. Palliative and Supportive Care 13(6), 1631–1641.CrossRefGoogle ScholarPubMed
Applebaum, AJ, Buda, KL, Schofield, E, et al. (2018) Exploring the cancer caregiver's journey through web-based meaning-centered psychotherapy. Psycho-Oncology 27(3), 847–856.CrossRefGoogle ScholarPubMed
Breitbart, W (2002) Spirituality and meaning in supportive care: Spirituality and meaning-centered group psychotherapy interventions in advanced cancer. Supportive Care in Cancer 10(4), 272–280.CrossRefGoogle ScholarPubMed
Breitbart, W, Rosenfeld, B, Pessin, H, et al. (2000) Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 284(22), 2907–2911.CrossRefGoogle ScholarPubMed
Breitbart, 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(1), 21–28.CrossRefGoogle ScholarPubMed
Breitbart, 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(12), 1304–1309.CrossRefGoogle ScholarPubMed
Breitbart, 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(7), 749–754.CrossRefGoogle ScholarPubMed
Breitbart, 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(15), 3231–3239.CrossRefGoogle ScholarPubMed
Chochinov, HM, Krisjanson, LJ, Hack, TF, et al. (2006) Dignity in the terminally ill: Revisited. Journal of Palliative Medicine 9(3), 666–672.CrossRefGoogle ScholarPubMed
Da Ponte, G, Ouakinin, S and Breitbart, W (2017) Adaptation of meaning centered psychotherapy to Portuguese language. In: Abstract Manual of the America Psychosomatic Society, 75th Annual Scientific Meeting, Seville, Spain, A27.Google Scholar
Da Ponte, G, Ouakinin, S and Breitbart, W (2018a) Adaptation of meaning centered psychotherapy to Portuguese population. In: Presented at 1st International Congress of Psycho-Oncology, Lisbon, Portugal.Google Scholar
Da Ponte, G, Santo, JE, Santos, H, et al. (2018b) Meaning centered psychotherapy: The state of the art. Current Psychiatry Reviews 14(3), 152–159.CrossRefGoogle Scholar
Devoldre, I, Davis, MH, Verhofstadt, LL, et al. (2015) Empathy and social support provision in couples: Social support and the need to study the underlying processes. The Journal of Psychology 144(3), 259–284.CrossRefGoogle Scholar
Edwards, SL (2016) Narrative analysis: How students learn from stories of practice. Nurse Researcher 23(3), 18–25.CrossRefGoogle Scholar
Fraguell, C, Limonero, N and Gil, F (2017) Psychological aspects of meaning-centered group psychotherapy: Spanish experience. Palliative and Supportive Care 16(3), 317–324.CrossRefGoogle Scholar
Frankl, V (1975) Man's Search for Ultimate Meaning. New York, NY: Plenum Press.Google Scholar
Frankl, VF (1992) Man's Search for Meaning, 4th ed.Boston, MA: Beacon Press.Google Scholar
Gil, F, Fraguell, C, Benito, L, et al. (2018) Meaning-centered psychotherapy integrated with elements of compassion: A pilot study to assess feasibility and utility. Palliative and Supportive Care 16(6), 643–647.CrossRefGoogle ScholarPubMed
Henoch, I and Danielson, E (2009) Existential concerns among patients with cancer and interventions to meet them: An integrative literature review. Psycho-Oncology 18(3), 225–236.CrossRefGoogle Scholar
Kim, Y and Schulz, R (2007) Benefit-finding in the cancer caregiving experience. Psychosom Medicine 69(3), 283–291.CrossRefGoogle ScholarPubMed
Kissane, DW, Bloch, S, Smith, GC, et al. (2003) Cognitive-existential group psychotherapy for women with primary breast cancer: A randomised controlled trial. Psycho-Oncology 12(6), 532–546.CrossRefGoogle ScholarPubMed
Kissane, DW, Grabsch, B, Clarke, DM, et al. (2007) Supportive-expressive group therapy for women with metastatic breast cancer: Survival and psychosocial outcome from a randomized controlled trial. Psychooncology 1(16), 277–286.CrossRefGoogle Scholar
Lee, V (2008) The existential plight of cancer: Meaning making as a concrete approach to the intangible search for meaning. Supportive Care in Cancer 16(7), 779–785.CrossRefGoogle ScholarPubMed
Lee, V, Cohen, SR, Edgar, L, et al. (2004) Clarifying “meaning” in the context of cancer research: A systematic literature review. Palliative and Supportive Care 2, 291–303.CrossRefGoogle ScholarPubMed
LeMay, K (2008) Treatment of existential distress in life threatening illness: A review of manualized interventions. Clinical Psychology Review 28, 472–493.CrossRefGoogle ScholarPubMed
Leng, J, Lui, F, Chen, A, et al. (2018) Adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population. Journal of Immigrant and Minority Health 20(3), 680–686.CrossRefGoogle ScholarPubMed
Leng, J, Lui, F, Huang, X, et al. (2019) Patient perspectives on adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population. Supportive Care in Cancer 27(9), 3431–3438.CrossRefGoogle ScholarPubMed
Lethborg, C, Schofield, P and Kissane, D (2012) The patient experience of undertaking meaning and purpose ‘MaP’ therapy in the setting of advanced cancer. Palliative and Supportive Care 4(10), 177–188.CrossRefGoogle Scholar
Lethborg, C, Kissane, DW and Schofield, P (2019) Meaning and Purpose (MaP) therapy I: Therapeutic processes and themes in advanced cancer. Palliative and Supportive Care 17(1), 13–20.CrossRefGoogle ScholarPubMed
Lichtenthal, WG (2010) Effects of directed written disclosure on grief and distress symptoms among bereaved individuals. Death Studies 34(6), 475–499.CrossRefGoogle ScholarPubMed
Lichtenthal, WG and Breitbart, W (2015) The central role of meaning in adjustment to the loss of a child to cancer: Implications for the development of meaning- centered grief therapy. Current Opinion in Supportive and Palliative Care 9(1), 46–51.CrossRefGoogle ScholarPubMed
Lichtenthal, WG, Applebaum, A and Breitbart, W (2011) Using mixed methods data to adapt meaning-centered psychotherapy for bereaved parents. In: International Psycho-Oncology Society 13th World Congress. Antalya, Turkey.Google Scholar
Lichtenthal, WG, Currier, JM and Keesee, NJ (2013) Sense and significance: A mixed methods examination of meaning making after the loss of one's child. Journal of Clinical Psychology 66(7), 791–812.Google Scholar
Lichtenthal, WG, Catarozoli, C, Masterson, M, et al. (2019) An open trial of meaning-centered grief therapy: Rationale and preliminary evaluation. Palliative and Supportive Care 17(1), 2–12.CrossRefGoogle ScholarPubMed
Lieblich, A and Tuval-Mashiach, RZ (1998) Narrative Research: Reading Analysis, and Interpretation. Thousand Oaks, CA: Sage Publications.CrossRefGoogle Scholar
Limonero, JT, Tomás-Sábado, J and Gómez-Romero, MJ (2014) Evidence for validity of the brief resilient coping scale in a young Spanish sample. The Journal of Psychology 17, E34.Google Scholar
McClain, CS, Rosenfeld, B and Breitbart, W (2003) Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet 361(9369), 1603–1607.CrossRefGoogle ScholarPubMed
Neimeyer, R (2000) Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies 24(6), 541–558.CrossRefGoogle ScholarPubMed
Nelson, CJ, Rosenfeld, B, Breitbart, W, et al. (2002) Spirituality, religion, and depression in the terminally ill. Psychosomatics 43(3), 213–220.CrossRefGoogle ScholarPubMed
Park, CL, Edmondson, D, Fenster, JR, et al. (2008) Meaning making and psychological adjustment following cancer: The mediating roles of growth, life meaning, and restored just-world beliefs. Journal of Consulting and Clinical Psychology 76(5), 863–875.CrossRefGoogle ScholarPubMed
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(2), 140–146.CrossRefGoogle ScholarPubMed
Rosenfeld, B, Cham, H, Pessin, H, et al. (2018) Why is meaning-centered group psychotherapy (MCGP) effective? Enhanced sense of meaning as the mechanism of change for advanced cancer patients. Psychooncology 27(2), 654–660.CrossRefGoogle ScholarPubMed
Spiegel, D and Bloom, JR (1981) Group support for patients with metastatic cancer: A randomized outcome study. Archives General Psychiatry 38, 527–533.CrossRefGoogle ScholarPubMed
Sutkevičiūtė, M, Stančiukaitė, M and Bulotienė, G (2017) Individual meaning-centered psychotherapy for palliative cancer patients in Lithuania. A case report. Acta Medica Lituanica 24(1), 67–73.CrossRefGoogle ScholarPubMed
Tedeschi, RG and Calhoun, LG (2004) Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry 15, 1–18.CrossRefGoogle Scholar
Tomich, PL (2002) Five years later: A cross-sectional comparison of breast cancer survivors with healthy women. Psychooncology 11(2), 154–169.CrossRefGoogle ScholarPubMed
Ussher, J, Kirsten, L and Butow, P (2005) What do cancer support groups provide which other supportive relationships do not? The experience of peer support groups for people with cancer. Social Science & Medicine 62, 2565–2576.CrossRefGoogle ScholarPubMed
van der Spek, N, Vos, J, van Uden-Kraan, C, et al. (2013) Meaning making in cancer survivors: A focus group study. PLoS One 8(9), 22–26.CrossRefGoogle ScholarPubMed
van der Spek, N, Vos, J, van Uden-Kraan, CF, et al. (2014) Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: Protocol of a randomized controlled trial. BMC Psychiatry 14(1), 14–22.CrossRefGoogle ScholarPubMed
van der Spek, N, Vos, J, van Uden-Kraan, CF, et al. (2016) Efficacy of meaning-centered group psychotherapy for cancer survivors: A randomized controlled trial. Psychological Medicine 47(11), 1990–2001.CrossRefGoogle Scholar
Vos, J and Vitali, D (2018) The effects of psychological meaning-centered therapies on quality of life and psychological stress: A metaanalysis. Palliative and Supportive Care 16(5), 608–632.CrossRefGoogle ScholarPubMed