Supportive‐expressive group therapy: The transformation of existential ambivalence into creative living while enhancing adherence to anti‐cancer therapies

Abstract

Supportive-Expressive Group Therapy (SEGT) has been developed and manualised in the research setting, but there have been few clinical accounts of its utility. In this qualitative review of its application in the Melbourne-based randomised control trial (RCT) for women with advanced breast cancer, SEGT is considered from the perspective of the structure and framework of therapy, its therapists, the issues that develop in exploring its common themes and what constitutes a well functioning group. Groups move through identifiable developmental phases. The mature group process transforms existential ambivalence into creative living, evidenced by humour, celebration, assertiveness, altruism, new creative pursuits and eventually courageous acceptance of dying. Challenges and pitfalls include avoidance, non-containment of ambivalence, intolerance of difference, anti-group phenomena and splitting. A key element is the medicalization of the group culture whereby members and co-therapists explore health beliefs and attitudes about care. This promotes compliance with anti-cancer treatments, including both the initiation of and perseverance with chemotherapy. This mechanism could prove to be a potentially important pathway in promoting longer survival.

Structural equation modeling: a study of the impact of the breast cancer psychosocial pathway (diagnosis, surgery and treatment)

“…Para além disso, comprova-se que o recurso a apoio psicológico pode reduzir o impacto psicossocial no momento dos tratamentos, o que reforça a necessidade de realizar uma abordagem multidisciplinar na intervenção em oncologia e, para além disso, reforça a importância dos resultados de vários estudos, que se preocupam em analisar qual o tipo de intervenção psicológica com maiores benefícios emocionais (Hack & Degner, 2004;Kissane et al, 2007;Kissane et al, 2004;Spiegel et al, 1999;Spiegel & Giese-Davis, 2002).…”

Management of Depression in Terminally Ill Patients – A Critical Review

“…The goals of SEGT are to build bonds, express emotions, detoxify death, redefine life's priorities, fortify families and friends, enhance doctor-patient relationships and improve coping. With such extraordinary influence on the cancer patient's life, SEGT actually protects cancer patients from developing new cases of clinical depression compared to those receiving usual cancer care [61].…”

Systems Modeling in Integrative Oncology

“…What is important is that treatment and follow-up compliance have been reported to be significantly worse in patients experiencing distressful psychosocial symptoms. [35][36][37] It is quite possible that treatment outcomes could be reduced in these patients as a consequence. The IOSM not only demonstrates the complex relationships that modulate these psychosocial symptoms, but it also highlights how various therapies may help in mitigating them.…”