Meaning-Centered Psychotherapy for Addressing Existential Distress of Patient/Caregiver Dyads Following Hematopoietic Stem Cell Transplantation: Feasibility and Acceptability

The purpose of this study is to learn whether Meaning-Centered Psychotherapy (MCP-Dyad) is practical, acceptable, and helpful to survivors and caregivers during recovery after stem cell transplant. MCP-Dyad is a meaning-focused support program. It is designed to help people stay connected to meaning, cope with difficult experiences, and communicate as a pair during recovery.

Study Overview

• Status: Not yet recruiting
• Conditions: Hematopoietic Stem Cell Transplant
• Intervention / Treatment: Behavioral: Meaning-Centered Psychotherapy; Behavioral: Usual Care

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Study Team; Phone Number: 507-422-5523; Email: rstnursingresearch@mayo.edu

Study Locations

• United States
  • Minnesota
    • Rochester, Minnesota, United States, 55905
      • Mayo Clinic
      • Contact: Study Team; Phone Number: 507-422-5523; Email: rstnursingresearch@mayo.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion criteria:

• Eligible patients and their caregivers must be adults (≥18 years)
• Patient must have undergone HSCT for a malignant blood cancer condition
• Caregiver must be the main support person (e.g., signed caregiving contract) for the HSCT patient
• Both the patient and their caregiver must be willing to participate in the study (dyads only)
• Be able to read, write, and speak in English
• Have access to a smartphone, computer, or tablet necessary for study participation and assessments. If a patient/caregiver dyad is interested in participating but does not have such a device, we will provide a Tracfone with smartphone capabilities for each member of the dyad

Exclusion criteria:

• Patients undergoing HSCT for nonmalignant conditions
• Patients and caregivers with severe cognitive or psychiatric impairment that may affect informed consent/participation
• Prisoners, pregnant women, and institutionalized persons
• Patients with severe cognitive or psychiatric impairment that would affect informed consent or participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Meaning-Centered Psychotherapy (MCP) Dyad; The MCP-Dyad arm participants will meet with an MCP-Dyad interventionist to engage in didactic content, reflection, and discussion to teach participants how to apply four sources of meaning to their lives	Behavioral: Meaning-Centered Psychotherapy; Survivor and caregiver dyads will participate in a seven-session, telehealth delivered Meaning-Centered Psychotherapy for Dyads (MCP-Dyad) program post-transplant.
Active Comparator: Usual Care; The standard of care arm will receive standard resources and consultations for HSCT care, which include a joint educational class for patients and caregivers before and after treatment.	Behavioral: Usual Care; Survivor and caregiver dyads will receive standard resources and consultations for hematopoietic stem cell transplantation (HSCT) care, which include a joint educational class for patients and caregivers before and after treatment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
MCP-Dyad acceptability as rated on the Acceptability of Intervention Measure (AIM)	Percentage of patients and caregivers who rate the intervention as 4/5 or higher on the 4-item Acceptability of Intervention Measure (AIM) questionnaire (benchmark: 70%). Higher scores signify greater agreement with intervention acceptability.	End of treatment (approximately 14 weeks)
Feasibility to accrue HSCT patient/caregiver dyads	Percentage of eligible caregivers approached who consent and enroll within 24 months.	2 years
MCP-Dyad intervention completion	Percentage of patients and caregivers in the MCP-Dyad cohort who complete at least 5 out of 7 intervention sessions (benchmark: 70%).	End of treatment (approximately 14 weeks)
MCP-Dyad Feasibility rating from participants (Feasibility of Intervention Measure-FIM)	Percentage of patients and caregivers who rate MCP-Dyad as 4/5 or higher on the Feasibility of Intervention Measure (FIM) 4-item questionnaire (benchmark: 70%). Higher scores signify greater agreement with intervention feasibility.	End of treatment (approximately 14 weeks)
MCP-Dyad retention	Percentage of randomized dyads with both members completing follow-up assessments (benchmark: 75%).	End of treatment (approximately 14 weeks)
MCP-Dyad intervention fidelity and protocol delivery	Percentage of audited sessions meeting intervention fidelity standards and delivered per protocol based on fidelity assessments (benchmark: ≥80%)	End of treatment (approximately 14 weeks)
MCP-Dyad appropriateness as rated on the Intervention Appropriateness Measure (IAM)	Percentage of patients and caregivers who rate the intervention as 4/5 or higher on the 4-item Intervention Appropriateness Measure (IAM) questionnaire (benchmark: 70%). Higher scores signify greater agreement with intervention appropriateness.	End of treatment (approximately 14 weeks)
MCP-Dyad dyad-level retention outreach	Percentage of missed sessions or assessments that receive outreach within 2 days (benchmark: ≥85%).	End of treatment (approximately 14 weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Benefit Finding Scale (BFS) score	The impact of MCP-Dyad on benefit finding will be measured using a slightly modified version of the Benefit Finding Scale (BFS), a 17-item measure that captures positive life challenges resulting from adversity (e.g., personal priorities, acceptance, daily activities, family, world views, relationship, purpose). Higher scores indicate greater benefit finding.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in Communal Coping Domains score	The Communal Coping Domains instrument assesses how patients and caregivers manage health-related behavior change, particularly in the context of health threats by measuring shared perceptions, confidence, and behaviors. There are three tailored subscales: use of communal coping (how frequently dyads use joint efforts to manage health threats), how confident the dyad is in working together to manage health, and beliefs about communal coping strategies. Responses for the use of the communal coping domain range from 1(never) to 5 (very often), and responses for the couple efficacy and outcome efficacy range from 0 (not at all) to 10 (very much). Higher overall scores indicate greater confidence in patient/caregiver coping strategies.	8 weeks post-intervention
Change in survivor and caregiver health-related quality of life.	The impact of MCP-Dyad on patient and caregiver health-related quality of life will be assessed using the Functional Assessment of Cancer Therapy -Bone Marrow Transplant (FACT-BMT). The patient instrument is a multidimensional measure of quality of life in adult HSCT patients. Each item is rated from 0 (not at all) to 4 (very much) and is an assessment of symptoms over the past 7 days. Domains include social and family well-being, emotional well-being, functional well-being, and BMT-specific concerns. Higher scores overall indicate better quality of life.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in survivor and caregiver existential distress	The impact of MCP-Dyad on the patient and caregiver's meaning and purpose (increased meaning and purpose equivalent to less existential distress) will be measured using the 48-item Life Attitude Profile-Revised (LAP-R) instrument. It has six domains (purpose, coherence, life control, death acceptance, existential vacuum, goal seeking) that make up two subscales, the Personal Meaning Index and Existential Transcendence. Higher scores generally indicate a more positive attitude towards life.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in survivor and caregiver spiritual well-being	The impact of MCP-Dyad on the patient's and caregiver's spiritual well-being will be measured using the Functional Assessment of Chronic Illness Therapy Spiritual Well-being (FACIT-Sp) Scale. It has two subscales, one for faith and another for meaning/peace. Higher scores indicate greater spiritual well-being.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in survivor and caregiver mutuality (quality of relationship)	The impact of MCP-Dyad on survivor and caregiver mutuality will be measured using Mutuality Scale (MS). The Mutuality Scale measures the positive quality of the relationship between the care recipient and the caregiver. Grounded in the concept of mutuality (degree of love, reciprocity, shared pleasurable activities, and shared values) in the patient/caregiver relationship. There is a four-domain structure with items rated from 0 (not at all) to 4 (a great deal) with question stems examining varies aspects of the relationship (e.g., how much do you enjoy spending time together). Higher overall scores indicate greater mutuality.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in dyadic adjustment (couples only)	The impact of MCP-Dyad in couples will be measured using the Revised Dyadic Adjustment Scale (RDAS). The RDAS is a self-report measure of relationship quality in couples. It assesses dyadic consensus, dyadic satisfaction, and dyadic cohesion to give an overall index of marital quality. The rating scale is 0 (always disagree) to 5 (always agree). Higher overall scores indicates greater relationship satisfaction.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in illness-related communication	The change in illness-related communication will be measured using the Social Constraints Scale. This scale measures the extent to which individuals perceive their social environment, particularly close relationships, as a limiting or discouraging their ability to express thoughts and feelings related to a stressful experience. Items are rated from 1(never) to 4 (very often). Higher scores are equivalent to more social constraints in the relationship.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in survivor and caregiver needs/distress	The impact of MCP-Dyad on the survivor and caregiver's needs/distress will be measured using the Cancer SupportSource Survivors: CCS-15+ and the CancerSupportSource-Caregiver: CCS-Caregiver-18+ instruments. Survivors and caregivers will rate their level of concern from 0 (not at all) to 4 (very serious concern). Questions for survivors focus on emotional well-being, symptom burden & impact, body image & healthy lifestyle, health care team communication, relationships & intimacy. Questions for caregivers focus on 5 areas of concern (emotional well-being, survivor well-being, caregiving tasks, finances, and healthy lifestyle) and areas of desired support. A total score for distress is recommended based on 18 items.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in survivor and caregiver psychological distress	The impact of MCP-Dyad on psychological distress will be measured using 2 anxiety and 2 depression questions from the CCS-15+ and the CCS-Caregiver-18+. These questions have established clinical cut offs. Scores range from 0 to 8. Survivor scores of 3 or above signify clinically significant anxiety or depression. Caregiver anxiety scores of 4 and above, and depression scores of 3 or above, indicate clinically significant distress.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in Dyadic Relationship Scale score	The Dyadic Relationship Scale is a brief dyadic measure assessing positive dyadic interaction and negative dyadic strain from both caregiver and care recipient perspectives. The caregiver version includes 11 items and the care recipient version includes 10 items, with two subscales: positive dyadic interaction and negative dyadic strain.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention
Change in interdependence of survivor and caregiver	The Inclusion of Other in the Self Scale is a single-item pictorial measure of perceived relationship closeness and self-other overlap. Respondents select one of seven increasingly overlapping circle pairs to represent their relationship with a specified other person, with higher scores indicating greater perceived closeness.	Baseline, End of treatment (approximately 14 weeks), 8 weeks post-intervention

Collaborators and Investigators

• Sponsor: Mayo Clinic
• Investigators: Principal Investigator: Natalie McAndrew, PhD, RN, Mayo Clinic

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2026
• Primary Completion (Estimated): February 28, 2028
• Study Completion (Estimated): April 30, 2028

Study Registration Dates

• First Submitted: May 12, 2026
• First Submitted That Met QC Criteria: May 12, 2026
• First Posted (Actual): May 19, 2026

Study Record Updates

• Last Update Posted (Actual): August 12, 2026
• Last Update Submitted That Met QC Criteria: August 10, 2026
• Last Verified: August 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: 26-005192

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No