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Meaning and Purpose (MaP) therapy II: Feasibility and acceptability from a pilot study in advanced cancer

  • David W. Kissane (a1) (a2) (a3), Carrie Lethborg (a2) (a4), Joanne Brooker (a1) (a2), Courtney Hempton (a1) (a2), Sue Burney (a1) (a5), Natasha Michael (a3) (a6), Margaret Staples (a1), Tanya Osicka (a1), Merlina Sulistio (a3), Jeremy Shapiro (a7) and Hilary Hiscock (a2)...

Abstract

Objective

Meaning and Purpose (MaP) therapy aims to enhance meaning-based coping through a life review that focuses on the value and worth of the person, key relationships, sources of fulfillment, roles, and future priorities in living life out fully. We sought to test the feasibility and acceptability of a six-session model of MaP therapy against a wait-list control cohort in a pilot study seeking effect sizes on measures of adaptation.

Method

We randomized patients with advanced cancer to MaP therapy or wait-list control, with measures administered at baseline and after 6–8 weeks. Wait-list patients could then crossover to receive therapy, with further measures collected postintervention. Adherence to the manualized model was sustained through weekly supervision and fidelity coding of recorded sessions. We used generalized estimating equations to control for baseline and any correlation of data.

Result

From 134 eligible participants, 57 (43%) consented, and 40 of 45 (89%) offered therapy completed 6 sessions. Key barriers to consenting patients were poor health (15 refusers and 4 withdrawals) and death intervened in 6 participants. MaP therapy generated adequate effect sizes in posttraumatic growth (new possibilities, appreciation of life, and personal strength) and life attitudes (choices and goal seeking) to permit calculation of power for a formal randomized, controlled trial.

Significance of results

Delivery of this model of existentially oriented therapy is feasible and acceptable to patients. A properly powered randomized controlled trial is justified to examine the efficacy of this intervention.

Copyright

Corresponding author

Author for correspondence: David W. Kissane, AC, MD, MPM, FRANZCP, FAChPM, FACLP, Department of Psychiatry, Monash University, Block P, Level 3, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia. E-mail: david.kissane@monash.edu

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