Efficacy of Psychotherapeutic Interventions in the Treatment of Breast Cancer Patients

Authors

DOI:

https://doi.org/10.32626/2227-6246.2022-58.156-182

Keywords:

cancer patient, cancer, breast cancer, psychotherapy, cognitive behavioral psychotherapy, existential psychotherapy, psychodynamic psychotherapy, psycho-oncology

Abstract

The aim of the article is to provide a theoretical review of methods of psychological assistance for breast cancer patients to describe the most effective ways to apply them in the work of a psychotherapist, taking into account the characteristics of patients and disease specifics.

Methods of the research. The following theoretical research methods were used to solve the tasks: categorical and structural-functional methods, as well as analysis, synthesis, generalization, systematization, and comparison.

Results and discussion. Based on the conducted theoretical analysis, three main psychotherapeutic approaches were identified, which are most often used in the work with breast cancer patients: cognitive behavioral psychotherapy, existential psychotherapy, and psychodynamic psychotherapy.

It has been established that the methods of psychological intervention used within these approaches were effective and have contributed to improving a patient’s psychological state and quality of life, and the results were maintained long after therapy ends. However, depending on the purpose of the psychological intervention, the stage of the treatment process, and the psychosocial characteristics of the client, their use may differ in certain circumstances. It was therefore determined that cognitive behavioral therapy should be optimally implemented in the early stages of breast cancer treatment to form adaptive coping strategies, promote psychological adaptation to the disease, overcome anxiety before treatment, reduce fatigue and pain, model immune function, and overcome insomnia and sexual dysfunction. In turn, existential therapy leads to greater efficiency in solving interpersonal issues, promoting personal growth, finding meaning in life, overcoming existential fears, enhancing social support, and managing patient emotions. The use of this kind of psychotherapy has been found to be effective at any time during treatment, depending on the client’s needs, and had an advantage over other types of therapy in a group format. Among the approaches used in treating breast cancer patients, psychodynamic psychotherapy is the least researched. This type of intervention is highly effective when it comes to overcoming internal conflicts and reducing anxiety, depression, and fatigue.

The difference between psychotherapy and psychological counseling in the treatment of breast cancer patients was also outlined. A comparative analysis of the effectiveness of psychotherapy and social support groups was conducted. The latest approaches to psychotherapy with breast cancer patients were described.

Conclusions. The results of this review indicate that the choice of the optimal method of psychotherapeutic intervention for breast cancer patients will contribute to the rapid achievement of a positive outcome and its stability for a long time. In each specific case, the recommended type of therapy will depend on several factors: the stage of the treatment process and the stage of the disease, the patient’s request, his current psychological state, and psycho-social characteristics.

References

Orlova, T.V. (2011). Kratkaia istoriia i sovremennoe sostoianie psikhoterapii v palliativnoi onkologii [Brief history and current state of psychotherapy in palliative oncology]. Meditsinskaia psikhologiia v Rossii - Medical psychology in Russia, 5 [in Russian].

Abed, M., Hossein, J., Shahrbanoo, S., Masoud, G.L., & Hajhosseini, M. (2020). Effectiveness of intensive short-term psychodynamic psychotherapy on reduced death anxiety, depression and feeling of loneliness among women with breast cancer. Journal of Advanced Pharmacy Education & Research (Jan-Mar), 10(1), 121.

Abuladze, M., Cholikidze, T., Esakia, T., Tsitsilashvili, S., Koiava, N., Jokhadze, N., ... & Saganelidze, K. (2021). Group psychotherapy in young female cancer patients during COVId-19 pandemic. Annals of Oncology, 32, 1161.

Alizadeh, N., Mirzaian, B., & Abbasi, G. (2022). Comparison of the Effectiveness of Schema Therapy and Short-Term Psychodynamic Therapy on Psychological Capital in Females with Breast Cancer. Rooyesh-e-Ra- vanshenasi Journal (RRJ), 10(11), 229-240.

Amleh, M.F., & Jondi, N.J. (2021). The Effectiveness of a Counselling Program Based on Reflective Writing on Reducing Mental disorders Associated with Breast Cancer. Journal of Al-Quds Open University for Educational & Psychological Research & Studies, 12(36), 4.

Antoni, M.H., Lechner, S., diaz, A., Vargas, S., Holley, H., Phillips, K., ... & Blomberg, B. (2009). Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain, behavior, and immunity, 23(5), 580-591.

Antoni, M.H., Lehman, J.M., Kilbourn, K.M., Boyers, A.E., Culver, J.L., Alferi, S.M., ... & Carver, C.S. (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20.

Arico, d., Raggi, A., & Ferri, R. (2016). Cognitive behavioral therapy for insomnia in breast cancer survivors: a review of the literature. Frontiers in psychology, 7, 1162.

Aydin, E. (2008). Trauma and resilience in women diagnosed with breast cancer: A transactional analysis perspective. Transactional Analysis Journal, 38(4), 323-334.

Belay, W., Labisso, W.L., Tigeneh, W., Sahile, Z., Zergaw, A., Ejigu, A., ... & Haileselassie, W. (2022). The effect of interpersonal psychotherapy on quality of life among breast cancer patients with common mental health disorder: a randomized control trial at Tikur Anbessa Specialized Hospital. Supportive Care in Cancer, 30(1), 965-972.

Beutel, M.E., WeiBflog, G., Leuteritz, K., Wiltink, J., Haselbacher, A., Ruckes, C., ... & Brahler, E. (2014). Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial. Annals of oncology, 25(2), 378-384.

Blake-Mortimer, J., Gore-Felton, C., Kimerling, R., Turner-Cobb, J. M., & Spiegel, d. (1999). Improving the quality and quantity of life among patients with cancer: a review of the effectiveness of group psychotherapy. European Journal of Cancer, 35(11), 1581-1586.

Cohen, M., & Fried, G. (2007). Comparing relaxation training and cognitive- behavioral group therapy for women with breast cancer. Research on Social Work Practice, 17(3), 313-323.

Cruess, d.G., Antoni, M.H., McGregor, B.A., Kilbourn, K.M., Boyers, A.E., Alferi, S.M., ... & Kumar, M. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosomatic medicine, 62(3), 304-308.

dowlatabadi, M.M., Ahmadi, S.M., Sorbi, M.H., Beiki, O., Razavi, T.K., & Bidaki, R. (2016). The effectiveness of group positive psychotherapy on depression and happiness in breast cancer patients: A randomized controlled trial. Electronic physician, 8(3), 2175.

Fiorentino, L., & Ancoli-Israel, S. (2006). Insomnia and its treatment in women with breast cancer. Sleep medicine reviews, 10(6), 419429.

Gagnon, P., Fillion, L., Robitaille, M.A., Girard, M., Tardif, F., Cochrane, J.P., ... & Breitbart, W. (2015). A cognitive-existential intervention to improve existential and global quality of life in cancer patients: A pilot study. Palliative & supportive care, 13(4), 981-990.

Grassi, L., Sabato, S., Caruso, R., Tiberto, E., de Padova, S., Ruffilli, F., ... & Testoni, I. (2021). Reflecting on meaning in an existential-reorientation group psychotherapy approach for cancer patients: A qualitative thematic analysis. Palliative & Supportive Care, 1-8.

Hsiao, F.H., Jow, G.M., Kuo, W.H., Chang, K.J., Liu, Y.F., Ho, R.T., ... & Chen, Y.T. (2012). The effects of psychotherapy on psychological wellbeing and diurnal cortisol patterns in breast cancer survivors. Psychotherapy and Psychosomatics, 81(3), 173-182.

Iordachescu d.A., Paica C.I., Vladislav E.O., Gica C., Botezatu R., Panai- tescu A.M., ... & Gica N. (2021). Psychological intervention in breast cancer pathology. Romanian Journal of medical practice, 16(3), 78.

Kiley-Morgan, J., Thompson, T., Shravat, A., & Punt, L. (2021). The effect of integrative counselling on psychological well-being in adult patients with cancer: A mixed methods study. Counselling Psychology Quarterly, 1-19.

Kissane, d.W., Bloch, S., Smith, G.C., Miach, P., Clarke, d.M., Ikin, J., ... & McKenzie, d. (2003). Cognitive existential group psychotherapy for women with primary breast cancer: a randomized controlled trial. Psycho Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 12(6), 532-546.

Lukasiewicz, S., Czeczelewski, M., Forma, A., Baj, J., Sitarz, R., & Stanislawek, A. (2021). Breast Cancer - Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies - An Updated Review. Cancers, 13(17), 4287.

Ma, Y., Hall, d.L., Ngo, L.H., Liu, Q., Bain, P.A., & Yeh, G.Y. (2021). Efficacy of cognitive behavioral therapy for insomnia in breast cancer: a meta-analysis. Sleep Medicine Reviews, 55, 101376. DOI: https://doi.org/10.32626/2227-6246.2022-58 2022. Issue 58 McGregor, B.A., Antoni, M. H., Boyers, A., Alferi, S.M., Blomberg, B.B., &

Carver, C.S. (2004). Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer. Journal of psychosomatic research, 56(1), 1-8.

Meibodi, R.P., Meftagh, S.d., & Shahangian, S.S. (2021). The effect of positive psychotherapy on happiness and character strength in cancer patients. Journal of Education and Health Promotion, 10.

Nazarpour, S., Mohammadipour, F., Mohammadi, R., Goudarzi, F., & Es- maeilbeigy, d. (2021). The effect of telephone counselling and follow-up on empowering women with breast cancer undergoing chemotherapy. Health Care for Women International, 1-18.

Onyedibe, M.C.C., Ifeagwazi, C.M., & Charles S,U. (2021). The efficacy of group cognitive behavioural therapy in improving adaptive cognitive emotion regulation in Nigerian breast cancer patients. Counselling and Psychotherapy Research, 21(4), 1021-1031.

Oster, I., Svensk, A.C., Magnusson, E.V.A., Thyme, K.E., Sjodin, M., Astrom, S., & Lindh, J. (2006). Art therapy improves coping resources: a randomized, controlled study among women with breast cancer. Palliative & supportive care, 4(1), 57-64.

Qiu, J., Chen, W., Gao, x., xu, Y., Tong, H., Yang, M., ... & Yang, M. (2013). A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression. Journal of Psychosomatic Obstetrics & Gynecology, 34(2), 60-67.

Quesnel, C., Savard, J., Simard, S., Ivers, H., & Morin, C.M. (2003). Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastic breast cancer. Journal of consulting and clinical psychology, 71(1), 189.

Rosendahl, J., Alldredge, C.T., Burlingame, G.M., & Strauss, B. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, 74(2), 52-59.

Sajadian, A., Zahrakar, K., & Asadpour, E. (2021). Effectiveness of Transpersonal Therapy (Spiritual Therapy, Yoga-Meditation) in Reducing Fear of Cancer Recurrence in Breast Cancer Survivors: A Randomized Controlled Trial. Iranian Quarterly Journal of Breast Disease, 14(2), 50-63.

Spiegel, d., Morrow, G.R., Classen, C., Raubertas, R., Stott, P.B., Muda- liar, N., ... & Riggs, G. (1999). Group psychotherapy for recently diagnosed breast cancer patients: a multicenter feasibility study. Psycho Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 8(6), 482-493.

Sreevani, R., Reddemma, K., Chan, C.L., Leung, P.P.Y., Wong, V., & Chan, C.H.Y. (2013). Effectiveness of integrated body-mind-spirit group intervention on the well-being of Indian patients with depression: A pilot study. Journal of Nursing Research, 21(3), 179186.

Stagl, J.M., Lechner, S.C., Carver, C.S., Bouchard, L.C., Gudenkauf, L.M., Jutagir, d.R., ... & Antoni, M.H. (2015). A randomized controlled trial of cognitive-behavioral stress management in breast cancer: survival and recurrence at 11-year follow-up. Breast cancer research and treatment, 154(2), 319-328.

Straker, N. (1998). Psychodynamic psychotherapy for cancer patients. The Journal of psychotherapy practice and research, 7(1), 1.

Suh, S.R., & Lee, M.K. (2017). Effects of nurse-led telephone-based supportive interventions for patients with cancer: A meta-analysis. In Oncology nursing forum, 44, 4.

Tatrow, K., & Montgomery, G.H. (2006). Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: a meta-analysis. Journal of behavioral medicine, 29(1), 17-27.

Telli, M.L., Gradishar, W.J., & Ward, J.H. (2019). NCCN guidelines updates: breast cancer. Journal of the National Comprehensive Cancer Network, 17(5.5), 552-555.

Van der Pompe, G., duivenvoorden, H.J., Antoni, M.H., Visser, A., & Heij- nen, C.J. (1997). Effectiveness of a short-term group psychotherapy program on endocrine and immune function in breast cancer patients: An exploratory study. Journal of Psychosomatic Research, 42(5), 453466.

Van der Spek, N., Vos, J., van Uden-Kraan, C.F., Breitbart, W., Cuijpers, P., Holtmaat, K., ... & Verdonck-de Leeuw, I.M. (2017). Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial. Psychological medicine, 47(11), 1990-2001.

Vannorsdall, T.d., Straub, E., Saba, C., Blackwood, M., Zhang, J., Stearns, K., & Smith, K.L. (2021). Interventions for multidimensional aspects of breast cancer-related fatigue: a meta-analytic review. Supportive Care in Cancer, 29(4), 1753-1764.

Vos, J., Craig, M., & Cooper, M. (2015). Existential therapies: a meta-analysis of their effects on psychological outcomes. Journal of consulting and clinical psychology, 83(1), 115.

Vos, P.J., Visser, A.P., Garssen, B., duivenvoorden, H.J., & Haes, H.C.d. (2007). Effectiveness of group psychotherapy compared to social support groups in patients with primary, non-metastatic breast cancer. Journal of psychosocial oncology, 25(4), 37-60.

Weissflog, G., Braehler, E., Leuteritz, K., Barthel, Y., Kuhnt, S., Wiltink, J., ... & Beutel, M.E. (2015). does psychodynamic short-term psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial. Breast cancer research and treatment, 152(3), 581-588.

xu, J., xue, B., Li, L., Qiao, J., Redding, S.R., & Ouyang, Y.Q. (2022). Psychological interventions for sexual function and satisfaction of women with breast cancer: A systematic review and metaanalysis. Journal of clinical nursing.

Ye, M., du, K., Zhou, J., Zhou, Q., Shou, M., Hu, B., ... & Liu, Z. (2018). A metaanalysis of the efficacy of cognitive behavior therapy on quality of life and psychological health of breast cancer survivors and patients. Psychooncology, 27(7), 1695-1703.

Zeppegno, P., Krengli, M., Ferrante, D., Bagnati, M., Burgio, V., Farruggio, S., ... & Grossini, E. (2021). Psychotherapy with music intervention improves anxiety, depression and the redox status in breast cancer patients undergoing radiotherapy: a randomized controlled clinical trial. Cancers, 13(8), 1752.

Downloads

Published

2022-12-06

How to Cite

Nefedova, T. (2022). Efficacy of Psychotherapeutic Interventions in the Treatment of Breast Cancer Patients. Collection of Research Papers "Problems of Modern Psychology", (58), 156–182. https://doi.org/10.32626/2227-6246.2022-58.156-182