Therapy processes, progress, and outcomes for 2 therapies for gynecological cancer patients

Abstract

Objective Although a number of effective psychotherapies have been identified for cancer patients, little is known about therapy processes as they unfold the course of treatment and the role of therapy processes in treatment outcome. We used growth curve modeling to evaluate the associations between therapy processes and outcomes among gynecological cancer patients participating in two types of therapy. Methods Two hundred twenty five women newly diagnosed with gynecological cancer were randomly assigned to receive eight sessions of a coping and communication intervention (CCI) or a client-centered supportive therapy (SC). Participants completed measures of pre-intervention and post-intervention depression, working alliance after Session 2, and post-session progress and depressive symptoms after each session. Therapists completed measures of perceived patient progress. Results Both patients and therapists reported a steady increase in session progress and patients reported a steady decrease in depressive symptoms over the course of both the CCI and SC sessions. Perceived progress in one session predicted progress in the subsequent session. Early working alliance predicted improved session progress and reductions in post-session depressive symptoms over sessions. Working alliance did not predict pre-post treatment changes in depression. Patient-rated session progress predicted greater reductions in pre-to post-treatment depression, but therapist-rated progress did not. Conclusions For two types of treatment delivered to women diagnosed with gynecological cancer, patient-rated session progress and depressive symptoms rated over therapy sessions may serve as a yardstick that can be useful to therapists to gauge patient’s response to treatment.

The generic model of psychotherapy supervision: An analogized research-informing meta-theory.

“…The GMP in current perspective. The GMP, 30 plus years later, remains a most important conceptual contribution, a landmark development in psychotherapy research (Grawe, 1992) because it (a) has been profitably used as a research framework for organizing the vast array of psychotherapy process-outcome studies (e.g., Crits-Christoph et al, 2013;Orlinsky & Howard, 1986), (b) has stimulated treatment research study and instrument development over the decades (Harwood, Beutler, Castillo, & Karno, 2006;Kolden, 1991;Kolden et al, 2000;Saunders, Howard, & Orlinsky, 1989), and (c) continues to do so (e.g., Manne et al, 2017;Schröder, Orlinsky, Rønnestad, & Willutzki, 2015).…”

The Impact of Matching to Psychotherapy Preference on Engagement in a Randomized Controlled Trial for Patients With Advanced Cancer

“…In addition, all participants received free treatment, which may have mitigated the effect of treatment preference (i.e., because free treatment is often appreciated, even if it is not the treatment that sounds most appealing). Finally, although there is a substantial research literature demonstrating the relationship between therapeutic alliance and treatment outcome (Applebaum et al, 2012a ; Sturgiss et al, 2016 ; Manne et al, 2017 ), this study did not have sufficient power to analyze whether treatment outcome was mediated by therapy match/mismatch, particularly given that substantial differences in the effectiveness of these treatments has already been demonstrated (Breitbart et al, 2018 ).…”

Research progress on the psychological burden and intervention measures in cancer patients

“…The extent of psychological burden in different types of cancer patients also changes with the duration since diagnosis. Manne et al pointed out that the psychological resilience of patients with gynecological cancers decreases over time from diagnosis, with an increasing psychological burden (44); whereas in liver cancer patients, the psychological burden decreases over time from diagnosis (45). This phenomenon is also related to the different physical burdens of various types of cancer at different times post-diagnosis.…”