The Effect of Behavioral Intervention on the Psychological Distress of Holocaust Survivors with Cancer

Abstract

Methods: This study describes a particular psychological intervention offered to a unique self-selected population of cancer patients who, 50 years earlier, had experienced the extreme trauma of the Holocaust. A total of 45 patients in follow-up at the Outpatient Clinic of the Oncology Department at the Hadassah University Hospital were approached. Two self-reports were administered: the Brief Symptom Inventory to assess psychological distress, and the Impact of Events Scale to assess intrusion and avoidance. Results: There was a significant decrease in distress by the specific short-term psychological intervention used in this traumatized population. However, 3 months later the improvement virtually disappeared. Conclusion: This study failed to demonstrate a long-lasting effect of behavioral intervention upon Holocaust survivors with cancer.

Characteristics and methodological quality of 25 years of research investigating psychosocial interventions for cancer patients

“…Some investigators have pointed out the dearth of non-European American samples and the typical low statistical power of research in this area 29. Other research has noted the high levels of drop-out associated with psychosocial interventions for cancer patients 30, 31. Such methodological shortcomings may bias estimates of treatment efficacy 26, 32.…”

Structured Writing and Processing Major Stressful Events: A Controlled Trial

“…Repeated exposure to the associated feelings and images is thought to reduce their effect through extinction. This may be effected by imaginary or in vivo exposure [2, 3]. Confrontation may be evoked during therapeutic sessions or by carrying out specific assignments.…”

Which cancer patient completes a psychosocial intervention program?

“…Forty-one patients (61%) dropped out of the various intervention programs they were offered (case management, 1-3 sessions: brief crisis counselling, 6-7 sessions, cognitive behavioural therapy, 8-10 sessions). This high dropout rate, which is borne out in most of the extant studies (Baider et al, 1997;Cohen et al, 1995;Everson, 1999), may be explained by the timing of the therapy. The patients were in shock arising from the diagnosis, and, additionally, were preoccupied by grave medical-treatment decisions.…”

“…1. The relatively high rate of cancer patients who drop out of psychosocial intervention programs in the initial phase of the illness is born out in other research (Baider et al, 1997;Stefanek et al, 1997;Zabora et al, 1997), even in the situation when intervention was offered to every new cancer patient.…”

“…Some patients who did comply with therapy were less able to deny the diagnosis and its implications thereafter, were less hopeful, and were more apt to adopt a religious or an existential approach to their situation. Another study (Baider et al, 1997) reported that only 40.6% of a sample of cancer patients a year or more after diagnosis agreed to participate in a behavioural intervention program. The explanation given by those who refused was that coming to the clinic reminded them of 'having cancer'.…”