Brief supportive-expressive group therapy for partners of men with early stage prostate cancer: lessons learned from a negative randomized controlled trial
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The purpose of this paper is to report the results of a negative randomized controlled trial, which piloted brief supportive-expressive therapy (SET) for partners of men with prostate cancer, and to discuss lessons learned for future clinical trials.
Partners of men with newly diagnosed, non-metastatic prostate cancer were randomized to SET (n = 45) or usual care (n = 32). SET involved six weekly group sessions emphasizing emotional expression, social support, and finding meaning in the cancer experience. Measures of mood disturbance, marital satisfaction, and social support were administered to both partners and patients at baseline, post-program, and at 3- and 6-month follow-up.
There were no significant differences between SET and the control group for either patients or their wives on any outcome. Regardless of group membership, partners reported improvements in total mood disturbance (p = .011), tension (p < .001), anger (p = .041), confusion (p < .001), state anxiety (p = .001), and emotional support (p = .037), and patients reported improvements in tension (p = .003), emotional support (p = .047), positive interaction support (p = .004), and overall social support (p = .026).
Compared to the natural course of recovery, SET did not improve psychosocial outcomes for either men with prostate cancer or their wives. Methodological challenges experienced in implementing this trial yield valuable lessons for future research, including designing interventions relevant to unique problems faced by specific groups, being closely guided by previous research, and the potential utility of screening for distress as an inclusion criteria in intervention trials.
KeywordsProstate cancer Oncology Partners Supportive expressive therapy Mood disturbance
This study was supported by a grant through the Canadian Cancer Society Research Institute (formerly the National Cancer Institute of Canada, PI: B. Bultz). L. Carlson holds the Enbridge Research Chair in Psychosocial Oncology at the University of Calgary Cumming School of Medicine, co-funded by the Canadian Cancer Society Alberta/Northwest Territories Division and Alberta Cancer Foundation. C. Rouleau is supported by an Alberta Innovates Health Solutions (AIHS) Graduate Studentship and a Canadian Institutes of Health Research (CIHR) Doctoral Award. B. Bultz holds the Daniel Family Leadership Chair in Psychosocial Oncology. The sources of funding had no role in the study design; in the collection, analysis, or interpretation of data; in writing the manuscript; or in the decision to submit the manuscript for publication. The authors have no conflicts of interest to disclose.
Compliance with ethical standards
This study was approved by the University of Calgary Conjoint Health Research Ethics Board.
This study was supported by a grant through the Canadian Cancer Society Research Institute (formerly the National Cancer Institute of Canada, PI: B. Bultz).
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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