Overview
Life-threatening physical illness may powerfully re-activate existential conflict. There is little evidence to date on the effectiveness of relationship-focused therapies in this patient group.The aim of this study is to pilot a psychodynamic treatment for patients with advanced cancer and high psychological distress.
Description
Severely physically ill patients may experience existential distress symptoms including helplessness, hopelessness, death anxiety, perceived burdensomeness and a sense of pointlessness. The latter can significantly interfere with end-of-life care processes and outcomes (receipt of treatment according to preferences, expression of desire for hastened death). So far, empirically tested psychotherapeutic programs in advanced life-threatening illness have predominantly been ultra-short and applied supportive and resource-oriented techniques. Psychodynamic treatment allows to address clinically significant existential distress through its conceptualization from early relational life experiences.
The aim of this study is to pilot a psychodynamic treatment for patients with advanced cancer and high psychological distress.The inverstigators will
- analyse the feasibility of the treatment, and
- investigate changes in process- and patient-relevant outcomes over the course of the treatment
The inverstigators will conduct a single-group pre-post study with five assessment points in which 50 adult patients diagnosed with advanced cancer will receive a manualized psychodynamic short-term therapy. Target parameters are assessed by diagnostic interviews, focus interviews, self-assessment questionnaires as well as electronic patient records. For research objective b) the investigators will compare the intervention group with a matched comparison group of a longitudinal cohort sample (NCT04600206). Matching will be based on stress level, demographic, and medical parameters across the 5 assessment points.
Eligibility
Inclusion Criteria:
- 18 years and older
- UICC stage IV solid tumor
- Informed consent
- Current physical condition that allows for at least 12 therapy sessions
- Indication: Presence of a mental disorder with existential stress and limitations in coping capacity
Exclusion Criteria:
- Acute suicidality
- Psychotic disorder (ICD-10: F2 diagnosis)
- Substance dependence or abuse (ICD-10: F1 diagnosis)
- Structural deficits that interfere with attending to regular appointments
- Other psychotherapeutic treatment
- Severe cognitive impairment
- Severe physical impairment
- Insufficient German to give informed consent and complete self-report questionnaires