Herschbach, P., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., Henrich, G., … Dinkel, A. (2010). Group psychotherapy of dysfunctional fear of progression in patients with chronic arthritis or cancer. Psychotherapy and Psychosomatics, 79, 31–38.
To examine the effects of generic psychotherapeutic interventions on dysfunctional fear of progression (FoP)
Randomization was stratified by diagnosis, and participants were blinded with regard to group assignment. The intervention group received four sessions of group psychotherapy, each 90 minutes. The first group received cognitive behavioral group therapy (CBT) and a manual that was structured with content, topics, and interventions. The supportive experiential group therapy (SET) had a manual with regard to structure, but it was less prescriptive in content than was the CBT manual. The groups were led by psychotherapists who had had three years or more of clinical experience or were in the final phase of training. Sessions were recorded, to monitor integrity. Measures were taken at the initial session, before discharge, at three months, at 12 months, and after discharge. The control group provided data at the initial, before-discharge, and after-discharge points only. The intervention groups received booster telephone calls at six and nine months after discharge. The control group was sampled in the same clinics as were other patients and at one year after the completion of the intervention, using the same eligibility criteria.
Active treatment and transition phase
Single-blind partially longitudinal randomized controlled study
Both interventions were associated with a decrease in FoP over time, but only among cancer patients. The two interventions did not differ in reducing FoP. A significant interaction between time and illness group emerged for anxiety, depression, and the mental component of health-related quality of life, indicating an improvement in cancer patients. The intervention had no effect on any of the secondary outcomes.
Dysfunctional FoP can be identified and targeted with brief group interactions. These interventions may reduce FoP, especially in populations with cancer. The intervention used here did not appear to have a long term benefit related to symptoms of depression.
Dealing with FoP is important in the care of cancer survivors. Findings of this study suggest that dysfunctional fear can be identified and that interventions can be appropriately targeted. While the intervention in this study did not show a lasting benefit related to depression, the study does provide potential approaches to identifying patients who may benefit from interventions to address fear.