A Randomized Controlled Trial of a Brief Psychoeducational Support Group for Partners of Early Stage Breast Cancer Patients

Principal Investigator: Barry Bultz, Ph.D., R. Psych.

Tom Baker Cancer Centre, and University of Calgary, Calgary, Alberta, Canada,

Template for Caregiver Intervention Description

1. Summary of Intervention

The partner’s psychoeducational group met one evening a week for 1.5–2 h over 6 weeks. Three series of groups were run over the course of a year and sessions were co-facilitated by two experienced psychologists. To maintain consistency, both therapists attended all sessions and the same format was followed for each of the three groups. The psychoeducational intervention was designed with two primary components in mind: education and support. The first two sessions of the group were educational in nature and provided partners with information regarding both medical and psychosocial aspects of the illness. In the first session, a video excerpt from a topical television news program was shown, which featured men in similar life situations talking about the impact of their wives’ breast cancer diagnosis had on them and their relationships. It served both as a catalyst for discussion, and as a form of modeling, in that it demonstrated men sharing their experiences, challenges and coping strategies in a frank manner. During the second session, an invited medical oncologist specializing in breast cancer treatment provided information about staging, treatment and risk of recurrence, and responded to questions from the patients’ partners. Having a medical oncologist present early in the course of the program allowed the men (most of whom had previously accompanied their partners during medical consultations at the Breast Cancer Clinic) to ask the questions they had not previously asked (or had been afraid to ask) in the presence of their partners. It also provided a realistic context for risk assessment that might serve as a counterfoil for any tendency among group members toward excessive reliance on denial or avoidance, which might inhibit discussion in the group during subsequent sessions. The following four sessions were relatively unstructured, with the focus on helping partners explore their feelings, deal with individual concerns, and confront their fears and anxieties. In doing so, they worked toward strengthening their relationships. These four sessions provided a protective and therapeutic milieu for partners to discuss their fears and challenges (e.g. communicating with partners about cancer, sexuality, how to provide emotional support, body image issues, genetic risk for daughters, fear of recurrence, death, and the dying process). The intervention resulted in reduced mood disturbance in caregivers. Marital satisfaction and level of support remained steady for patient partners of caregiver’s who received the intervention, whereas there was a deterioration in the marital satisfaction and level of support for those whose caregivers were in the control condition. Benefits persisted at 3-month follow-up.

Key search terms: Psychoeducation, support group, emotional expression.

2. Intervention Materials

A video excerpt from the ABC program 20/20, from 1995 was shown, which featured men in similar life situations talking about the impact of their wives’ breast cancer diagnosis had on them and their relationships. Any similar video perhaps locally produced could substitute. It was intended as a stimulus to suggest relevant issues and a starting point for discussion.

Contact for more information:

Barry D. Bultz, Ph.D.

Department of Psychosocial Resources,

Tom Baker Cancer Centre

1331-29 Street NW, Calgary, Alberta,

Canada T2N 4N2.

Tel.: (403) 355-3205

fax: (403) 355-3206

e-mail: bdbultz@ucalgary.ca

3. Implementing the Intervention

Training qualifications and guidelines for those delivering the intervention:

Trained mental health professionals experienced working with cancer patients and their families and experienced with group facilitation are required. No intervention specific training program exists. A description of the intervention that may provide sufficient guidance for trained therapists is provided in the publication: Bultz, Speca, Brasher, Geggie and Page. (2000). A randomized trial of a brief psychoeducational support group for partners of early stage breast cancer patients. Psycho-Oncology, 9: 303-313. During the 2nd of six sessions, an invited medical oncologist specializing in breast cancer treatment provided information about staging, treatment and risk of recurrence, and responded to questions from the patients’ partners.

Estimated costs of implementing the intervention: $ 5,000.00

Requires trained mental health professionals with experience in oncology and with group facilitation. A trained Medical Oncologist for one session would be helpful.

The intervention is flexible enough to address local and/or culturally specific concerns.

4. For more information

  1. Carlson, L.E., Ottenbreit, N., St. Pierre, M., Bultz, B.D. (2001). Partner understanding of the breast and prostate cancer experience. Cancer Nursing, 24(3), 231-239.
  2. Carlson, L.E., Bultz, B.D., Speca, M., & St.Pierre, M.(2000).Partners of cancer patients: Part I. Impact, adjustment and coping across the illness trajectory. Journal of Psychosocial Oncology, 18(2); 39-63.
  3. Carlson, L.E., Bultz, B.D., Speca, M., & St.Pierre, M. (2000).Partners of cancer patients: Part II. Current psychosocial interventions and suggestions for improvement. Journal of Psychosocial Oncology, 18(3); 33-43.
  4. Dittmann, Melissa, (2003) Coping with cancer through social connection. A psychosocial treatment model at Walter Reed Army Medical Center helps breast cancer patients and their partners find comfort and answers. The American Psychological Association Monitor, Volume 34, No. 3 March 2003, http://www.apa.org/monitor/mar03/coping.html