Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress

Cristian Ochoa, Anna Casellas-Grau, Jaume Vives, Antoni Font, Josep-Maria Borràs, Cristian Ochoa, Anna Casellas-Grau, Jaume Vives, Antoni Font, Josep-Maria Borràs

Abstract

There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months' follow-up. Participants' PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.

Keywords: Cancer survivors; Positive psychology; Positive psychotherapy; Posttraumatic growth; Quasi-experiment.

Figures

Figure 1
Figure 1
CONSORT figure of participants’ allocation.
Figure 2
Figure 2
Psychological outcomes along assessments: pre-intervention (T0), post-intervention (T1), 3 months follow-up (T2), and 12 months follow-up (T3). d= between-stage differences. PCL-C: posttraumatic stress; HADS: mood; PTGI: positivechanges experienced after trauma.

References

    1. Antoni M.H. American Psychological Association Press; Washington, DC: 2003. Stress Management Intervention for Women with Breast Cancer.
    1. Antoni M.H. Mini-review: Psychosocial intervention effects on adaptation, disease course and biobehavioral processes in cancer. Brain, Behavior and Immunity. 2012;30:88–98.
    1. Antoni M.H., Lechner S.C., Kazi A., Wimberly S.R., Sifre T., Urcuyo K.R., Philips K., Glük S., Carver C.S. How stress management improves quality of life after treatment for breast cancer. Journal of Consulting and Clinical Psychology. 2006;74:1143–1152.
    1. Blackburn I.-M., James I.A., Milne D.L., Baker C., Standart S., Garland A., Reichelt F.K. The revised cognitive therapy scale (CTS-R): Psychometric properties. Behavioural and Cognitive Psychotherapy. 2001;29:431–446.
    1. Carlson L.E., Waller A., Mitchell A.J. Screening for distress and unmet needs in patients with cancer: Review and recommendations. Journal of Clinical Oncology. 2012;30:1160–1177.
    1. Casellas-Grau A., Font A., Vives J. Positive psychology interventions in breast cancer. A systematic review. Psycho-Oncology. 2014
    1. Costa-Requena G., Gil F. Posttraumatic stress disorder symptoms in cancer: Psychometric analysis of the Spanish Posttraumatic Stress Disorder Checklist-Civilian version. Psycho-Oncology. 2010;19:500–507.
    1. Costa-Requena G., Pérez Martin X., Salamero Baro M., Gil Moncayo F. Discriminación del malestar emocional en pacientes oncológicos utilizando escalas de Ansiedad y Depresion Hospitalaria (HADS) Ansiedad y Estrés. 2009;15:217–229.
    1. De la Torre-Luque A., Gambara H., López E., Cruzado J.A. Psychological treatments to improve quality of life in cancer contexts: A meta-analysis. International Journal of Clinical and Health Psychology. 2016;16:211–219.
    1. Gil F., Grassi L., Travado L., Tomamichel M., Gonzalez J.R. Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients. Supportive Care in Cancer. 2005;13:600–606.
    1. Haberkorn J., Burbaum C., Fritzche K., Geser W., Fuchs D., Ocaña-Peinado F.M., Schubert C. Day-to-day cause-effect relations between cellular immune activity, fatigue and mood in a patient with prior breast cancer and current cancer-related fatigue and depression. Psychoneuroendocrinology. 2013;38:2366–2372.
    1. Heinrichs N., Zimmermann T., Huber B., Herschbach P., Russell D.W., Baucom D.H. Cancer Distress Reduction with a Couple-Based Skills Training: A Randomized Controlled Trial. Annals of Behavioral Medicine. 2011;43:239–252.
    1. Helgeson V.S., Reynolds K.A., Tomich P.L. A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology. 2006;74:797–816.
    1. Joseph S., Linley P.A. Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical Psychology Review. 2006;26:1041–1053.
    1. Moore A.M., Gambling T.C., Geller D.A., Youseff M.N., Hoffman K.E., Gemmell L., Likumahuwa S.M., Bovbjerg D.H., Marsland A., Steel J.L. A prospective study of posttraumatic growth as assessed by self report and family caregiver in the context of advanced cancer. Psycho-oncology. 2011;20:479–487.
    1. Morrill E.F., Brewer N.T., O’Neill S.C., Lillie S.E., Dees E.C., Carey L.A., Rimer B.K. The interaction of post-traumatic growth and post-traumatic stress symptoms in predicting depressive symptoms and quality of life. Psycho-oncology. 2006;17:1093–1098.
    1. Ochoa C., Casellas-Grau A. Positive Psychotherapy in Cancer: Facilitating Posttraumatic Growth in Assimilation and Accomodation of Traumatic Experience. In: Martin C.R., Preedy V.R., Vinood B.P., editors. Comprehensive Guide to Post-Traumatic Stress Disorder (pp. 113-127) Springer International Publishing Switzerland; Verna: 2015.
    1. Ochoa C., Castejon V., Sumalla E.C., Blanco I. Posttraumatic growth in cancer survivors and their significant others: Vicarious or secondary growth? Terapia Psicologica. 2013;31:81–92.
    1. Ochoa C., Sumalla E.C., Maté J., Castejón V., Rodríguez A., Blanco I., Gil F. Psicoterapia positiva grupal en cáncer. Hacia una atención psicosocial integral del superviviente de cáncer. Psicooncología. 2010;7:7–34.
    1. Penedo F.J., Molton I., Dahn J.R., Shen B.J., Kinsinger D., Traeger L., Siegel S., Schneiderman N., Antoni M. A randomized clinical trial of group-based cognitive-behavioral stress management in localized prostate cancer: Development of stress management skills improves quality of life and benefit finding. Annals of Behavioral Medicine. 2006;31:261–270.
    1. Perepletchikova F., Treat T.A., Kazdin A.E. Treatment integrity in psychotherapy research: Analysis of the studies and examination of the associated factors. Journal of Consulting and Clinical Psychology. 2007;75:829–841.
    1. Pérez-Sales P., Eiroa-Orosa F.J., Olivos P., Barbero-Val E., Fernández-Liria A., Vergara M. Vivo Questionnaire: A Measure of Human Worldviews and Identity in Trauma, Crisis, and Loss—Validation and Preliminary Findings. Journal of Loss and Trauma. 2012;17:236–259.
    1. Rashid T., Seligman M.E.P. Positive Psychotherapy. In: Corsini R.J., Wedding D., editors. Current Psychotherapies (pp. 461–498) CA: Cengage; Belmont: 2013.
    1. Roepke A.M. Psychosocial Interventions and Posttraumatic Growth: A Meta-Analysis. Journal of Consulting and Clinical Psychology. 2014;83:129–142.
    1. Sawyer A., Ayers S., Field A.P. Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: A meta-analysis. Clinical Psychology Review. 2010;30:436–447.
    1. Shakespeare-Finch J., Barrington A.J. Behavioural changes add validity to the construct of posttraumatic growth. Journal of Traumatic Stress. 2012;25:433–439.
    1. Sheppard V.B., Llanos A.A., Hurtado-de-Mendoza A., Tailor T.A., Adams-Campbell L.L. Correlates of depressive symptomatology in African-American breast cancer patients. Journal of Cancer Survivorship. 2013;7:292–299.
    1. Spiegel D. Mind matters in cancer survival. Psycho-Oncology. 2012;21:588–593.
    1. Sumalla E.C., Ochoa C., Blanco I. Posttraumatic growth in cancer: Reality or illusion? Clinical Psychology Review. 2009;29:24–33.
    1. Taylor S.E., Kemeny M.E., Reed G.M., Bower J.E., Gruenwald T.L. Psychological resources, positive illusions, and health. American Psychologist. 2000;55:99–109.
    1. Tedeschi R.G., Calhoun L.G. The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress. 1996;9:455–471.
    1. Vázquez C., Pérez-Sales P., Ochoa C. Posttraumatic growth: challenges from a cross-cultural viewpoint. In: Fava G.A., Ruini C., editors. Increasing psychological well-being across cultures (pp. 57–74) Springer International Publishing; New York, NY: 2014.
    1. Weathers F.W., Litz B.T., Huska J.A., Keane T.M. National Center for PTSD, Behavioral Science Division; Boston: 1994. PTSD Checklist—Civilian version.
    1. Widows M., Jacobsen P., Booth-Jones M., Fields K. Predictors of posttraumatic growth following bone marrow transplantation for cancer. Health Psychology. 2005;24:266–273.
    1. Woodworth R.D., O’Brien-Malone A., Diamond M.R., Schüz B. Happy days: Positive psychology interventions effects on affect in a N-of-1 trial. International Journal of Clinical and Health Psychology. 2016;16:21–29.
    1. Zigmond A.S., Snaith R.P. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983;67:361–370.

Source: PubMed

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