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Abstract
The aim of this study was to evaluate a manualized cognitive behavioral group intervention for early-stage breast cancer patients. Sixty-nine women were recruited at an Irish specialist oncology hospital and assigned to a 6-week cognitive behavior therapy (CBT) program or an educational control group. Participants were assessed at baseline, 6 weeks, and 6-month follow-up. Groups × Time (2 × 3) ANOVAs showed that the program did not lead to greater improvement on standardized measures of coping, quality of life, or mood compared with the control group. Regression analyses showed that maladaptive coping and distress at baseline were predictive of psychological adjustment at follow-up. Level of distress was also predictive of quality of life at follow-up. Repeated measures ANOVAs of data from cases in the intervention group showed that patients who completed the program showed significant improvement in problem severity, impact of problems, coping ability, and goal attainment from pre- to posttreatment, and these gains were maintained at follow-up for problem severity and impact of problems, but not for coping ability or goal attainment. Participation in the program did not lead to less health service usage during the period from baseline to follow-up, compared with the educational control group. A controlled trial provided limited evidence for the effectiveness of brief cognitive behavior intervention in enhancing psychological adjustment of early-stage breast cancer patients with nonclinically significant levels of psychological distress. Future research should evaluate the effectiveness of the program for patients with elevated levels of psychological distress and limited coping resources.
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This study was funded by grants from Saint Luke's Institute of Cancer Research, the Irish Research Council for Social and Human Sciences, UCD Seed Funding Scheme, and the Irish Cancer Society.