Meaning-based psychotherapy can help terminal patients

A psychotherapy technique including spirituality and finding meaning for life and death may improve quality of life and well-being of terminally ill patients. Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. Although most palliative care doctors and nurses are well informed about treating physical symptoms such as pain and nausea there are less definitive evidence on the treatment of non-physical symptoms in terminally ill patients. To address the need, Dr. William Breitbart and colleagues at Memorial Sloan-Kettering Cancer Center in New York have developed Individual Meaning-Centered Psychotherapy (IMCP). Studying 120 end stage cancer patients, the team assigned participants who were less likely to live more than six months to either attend seven hour-long sessions with a psychotherapist or to spend the same amount of time with a massage therapist. The psychotherapy sessions focused on topics like meaning, identity and hope, as well as the finiteness of life. The sessions also included reflection exercises and aimed to give patients a sense of peace and purpose in their lives. According to the results published in the Journal of Clinical Oncology, the psychotherapy group demonstrated significantly greater improvement in both spiritual well-being and quality of life. Psychotherapy patients also improved in dealing with the secondary outcomes of symptom burden and symptom-related distress but not in anxiety, depression, or hopelessness. In the 2-month follow-up assessment, the improvements observed for the IMCP group no longer existed. There was little or no benefit seen over the same time span for patients who were treated with massage. The study concluded that Meaning-Centered Psychotherapy has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Experts, however, suggest that using medications, meditation and other therapies may be more helpful in treating more complicated psychological problems such as anxiety and depression.