Date: 07 Jan 2006
Cognitive Behavioral Therapy Techniques for Distress and Pain in Breast Cancer Patients: A Meta-Analysis
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
This meta-analysis is the first to examine cognitive behavioral therapy (CBT) techniques for distress and pain specifically in breast cancer patients. Twenty studies that used CBT techniques with breast cancer patients were identified and effect sizes were calculated to determine (1) whether CBT techniques have a significant impact on distress and pain, (2) if individual or group treatments are more effective, (3) whether severity of cancer diagnosis influences distress and pain outcomes, and, (4) if there is a relationship between CBT technique efficacy for distress and pain. Results revealed effect sizes of d = 0.31 for distress (p < 0.05) and .49 for pain (p < 0.05), indicating that 62 and 69% of breast cancer patients in the CBT techniques treatment groups had less distress and less pain (respectively) relative to the control groups. Studies with individual treatment approaches had significantly larger effects compared to studies that employed group approaches for distress (p = 0.04), but not for pain (p > 0.05). There were no significant differences in effects between those with or without metastases (p > 0.05). The correlation between effect sizes for distress and pain was not significant (p = 0.07). Overall, the results support the use of CBT techniques administered individually to manage distress and pain in breast cancer patients. However, more well-designed studies are needed.
References marked with an asterisk indicate studies included in the meta-analysis.
American Cancer Society (ACS) (2004). Cancer Facts and Figures, Atlanta, GA, pp. 1–60.
*Bordeleau, L., Szalai, J. P., Ennis, M., Leszcz, M., Speca, M., Sela, R., et al. (2003). Quality of life in a randomized trial of group psychosocial support in metastatic breast cancer: Overall effects of the intervention and an exploration of missing data. J. Clin. Oncol. 21: 1944–1951.CrossRefPubMed
Bottomley, A. (1996). Group cognitive behavioural therapy interventions with cancer patients: A review of the literature. Eur. J. Cancer Care 5: 143–146.CrossRef
*Christensen, D. N. (1983). Postmastectomy couple counseling: An outcome study of a structured treatment protocol. J. Sex Marital Ther. 9: 266–275.PubMed
Cohen, J. (1992). A power primer. Psychol. Bull. 112: 155–159.CrossRef
*Davis, H. (1986). Effects of biofeedback and cognitive therapy on stress in patients with breast cancer. Psychol. Rep. 59: 967–974.PubMed
Devine, E. C., and Westlake, S. K. (1995). The effects of psychoeducational care provided to adults with cancer: Meta-analysis of 116 studies. Oncol. Nurs. Forum 22: 1369–1381.PubMed
Edelman, S., Craig, A., and Kidman, A. D. (2000). Group interventions with cancer patients: Efficacy of psychoeducational versus supportive groups. J. Psychosoc. Oncol. 18: 67–85.CrossRef
Genuis, M. L. (1995). The use of hypnosis in helping cancer patients control anxiety, pain and emesis: A review of recent empirical studies. Am. J. Clin. Hypn. 37: 316–325.PubMed
Glanz, K., and Lerman, C. (1992). Psychosocial impact of breast cancer: A critical review. Ann. Behav. Med. 14: 204–212.
Golden, R. N. (2004). Making advances where it matters: Improving outcomes in mood and anxiety disorders. CNS Spectr. 9(6 Suppl. 4): 14–22.PubMed
Henson, H. K. (2002). Breast cancer and sexuality. Sex. Disabil. 20: 261–275.CrossRef
Holland, J. C. (Ed.) (1998). Psycho-Oncology, New York: Oxford University Press.
Hunter, J. E., and Schmidt, F. L. (1990). Methods of Meta-Analysis, Newbury Park, CA: Sage.
*Larsson, G., and Starrin, B. (1992). Relaxation training as an integral part of caring activities for cancer patients: Effects on wellbeing. Scand. J. Caring Sci. 6: 179–185.PubMed
*Marchioro, G., Azzarello, F., Checchin, M., Perale, R., Segati, E., Sampognaro, F., et al. (1996). The impact of a psychological intervention on quality of life in non-metastatic breast cancer. Eur. J. Cancer 32: 1612–1615.CrossRef
*Molassiotis, A., Yung, H. P., Yam, B. M. C., Chan, F. Y. S., and Mok, T. S. K. (2002). The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: A randomized controlled trial. Support. Care Cancer 10: 237–246.CrossRefPubMed
Montgomery, G. H., David, D., Goldfarb, A. B., Silverstein, J. H., Weltz, C. R., Birk, J. S., and Bovbjerg, D. H. (2002). Sources of anticipatory distress among breast surgery patients. J. Behav. Med. 26: 153–164.CrossRef
Mundy, E. A., DuHamel, K. N., and Montgomery, G. H. (2003). The efficacy of behavioral interventions for cancer treatment-related side effects. Semin. Clin. Neuropsychiatry 8: 253–275.PubMed
National Comprehensive Cancer Network Distress Management Panel (2005, February 24). Clinical practice guidelines in oncology: Distress management, v. 1.2005 [Data file]. Available at NCCN Web site http://www.nccn.org
Newell, S. A., Sanson-Fisher, R. W., and Savolainen, N. J. (2002). Systematic review of psychological therapies for cancer patients: Overview and recommendations for future research. J. Natl. Cancer Inst. 94: 558–584.PubMed
Noyes, R. (1981). Treatment of cancer pain. Psychosom. Med. 43: 57–70.PubMed
Petronis, V. M., Carver, C. S., Antoni, M. H., and Weiss, S. (2003). Investment in body image and psychosocial well-being among women treated for early stage breast cancer: Partial replication and extension. Psych. Health 18: 1–13.CrossRef
Rehse, B., and Pukrop, R. (2003). Effects of psychosocial interventions on quality of life in adult cancer patients: Meta analysis of 37 published controlled outcome studies. Patient Educ. Couns. 50: 179–186.PubMed
*Sandgren, A. K., McCaul, K. D., King, B., O’Donnell, S., and Foreman, G. (2000). Telephone therapy for patients with breast cancer. Oncol. Nurs. Forum 27: 683–688.PubMed
Smith, M. L., Glass, G. V., and Miller, T. I. (1980). The Benefits of Psychotherapy, John Hopkins University Press, Baltimore.
*Spiegel, D., and Bloom, J. R. (1983). Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosom. Med. 45: 333–339.PubMed
Tasmuth, T., von Smitten, K., Hietanen, P., Kataja, M., and Kalso, E. (1995). Pain and other symptoms after different treatment modalities of breast cancer. Ann. Oncol. 6: 453–459.PubMed
Tjemsland, L., Soreide, J. A., and Malt, U. F. (1996). Traumatic distress symptoms in early breast cancer I: Acute response to distress. Psychooncology 5: 1–8.CrossRef
Trijsburg, R. W., van Knippenberg, F. C. E., and Rijpma, S. E. (1992). Effects of psychological treatment on cancer patients: A critical review. Psychosom. Med. 54: 489–517.PubMed
Zabora, J., Blanchard, C. G., Smith, E. D., Roberts, C.S., Glajchen, M., Sharp, J. W., et al. (1997). Prevalence of psychological distress among cancer patients across the disease continuum. J. Psychosoc. Oncol. 15: 73–87.CrossRef
- Cognitive Behavioral Therapy Techniques for Distress and Pain in Breast Cancer Patients: A Meta-Analysis
Journal of Behavioral Medicine
Volume 29, Issue 1 , pp 17-27
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Breast cancer
- cognitive behavioral
- Author Affiliations
- 1. Psychology Department, Good Shepherd Rehabilitation Hospital, Allentown, PA, USA
- 2. Integrative Behavioral Medicine Program, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, USA
- 3. Biobehavioral Medicine Program, Department of Oncological Sciences, Mount Sinai School of Medicine, New York, USA
- 4. Psychology Department, Good Shepherd Rehabilitation Hospital, 501 Saint John St., Allentown, Pennsylvania, 18103, USA