Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

A Scoping Review of Randomized Control Trials of Group Psychotherapy Interventions for Anxiety among Patients with Cancer (126710)

Seyma N Saritoprak 1
  1. City of Hope, Irvine, CALIFORNIA, United States

Background: Patients with a cancer diagnosis often experience anxiety throughout their cancer care from diagnosis to survivorship which can adversely affect outcomes. Unfortunately, many patients with cancer experience unmet needs specifically regarding psychological distress. Group psychotherapy can address the gap by reaching more patients and improving outcomes.  

Methods: The following search terms were used on PubMed, Scopus, and Embase: "Anxiety" and "Group psychotherapy" and "Cancer." Inclusion criteria included the following: a) adult patients with a cancer diagnosis in treatment or survivorship 2) randomized control trial study design 3) group-based intervention, and 3) assessment of anxiety.

Results: The search yielded 264 studies with an additional study found via snowballing methodology; a total of 27 studies met the inclusion criteria. The studies were predominantly two-armed trials. Group interventions varied across studies with a majority of studies utilizing Cognitive Behavioral Therapy (CBT) (N = 7), Meaning-Centered Group Psychotherapy (MCGP) (N = 4), Support Group Psychotherapy (SGP) (N = 3), Supportive Expressive Therapy (SET) (N = 3), and Acceptance and Commitment Therapy (ACT) (N = 3). The most common assessment of anxiety was the Hospital Anxiety and Depression Scale (N =10). In terms of effectiveness, 11 of the studies found significant improvements in anxiety scores between the group psychotherapy and control conditions. Four studies found Mindfulness-Based Cancer Recovery (MBCR) (N =1), ACT (N = 1), CBT (N =1), and MCGP (N =1) to yield significantly greater improvements in anxiety in comparison to other group psychotherapy interventions. Other studies (N = 11) did not find a significant difference in anxiety scores when comparing conditions. One study found mixed results.

Conclusions: The review provides insight into disseminating evidence-based care. Further three-armed studies are needed to examine distinct benefits. Incorporating group psychotherapy within oncology settings can increase access to effective interventions and improve psychological distress.

  1. Bränström, R., Kvillemo, P., Brandberg, Y., & Moskowitz, J. T. (2010). Self-report mindfulness as a mediator of psychological well-being in a stress reduction intervention for cancer patients—A randomized study. Annals of behavioral medicine, 39(2), 151-161.
  2. Breitbart, W., Rosenfeld, B., Gibson, C., Pessin, H., Poppito, S., Nelson, C., ... & Olden, M. (2010). Meaning‐centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho‐oncology, 19(1), 21-28.
  3. Breitbart, W., Rosenfeld, B., Pessin, H., Applebaum, A., Kulikowski, J., & Lichtenthal, W. G. (2015). Meaning-centered group psychotherapy: an effective intervention for improving psychological well-being in patients with advanced cancer. Journal of clinical oncology, 33(7), 749-754.
  4. Carlson, L. E., Tamagawa, R., Stephen, J., Drysdale, E., Zhong, L., & Speca, M. (2016). Randomized‐controlled trial of mindfulness‐based cancer recovery versus supportive expressive group therapy among distressed breast cancer survivors (MINDSET): long‐term follow‐up results. Psycho‐Oncology, 25(7), 750-759.
  5. Chambers, S. K., Occhipinti, S., Foley, E., Clutton, S., Legg, M., Berry, M., ... & Smith, D. P. (2017). Mindfulness-based cognitive therapy in advanced prostate cancer: a randomized controlled trial. Journal of Clinical Oncology, 35(3), 291-297.
  6. Courneya, K. S., Friedenreich, C. M., Sela, R. A., Quinney, H. A., Rhodes, R. E., & Handman, M. (2003). The group psychotherapy and home‐based physical exercise (group‐hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 12(4), 357-374.
  7. Evans, R. L., & Connis, R. T. (1995). Comparison of brief group therapies for depressed cancer patients receiving radiation treatment. Public Health Reports, 110(3), 306.
  8. Esmali, A., & Alizadeh, M. (2015). The effectiveness of group psychotherapy based on acceptance and commitment on increasing of mental health and the quality of women’s life with breast cancer. Biosciences Biotechnology Research Asia, 12(3), 2253-2260.
  9. Johns, S. A., Stutz, P. V., Talib, T. L., Cohee, A. A., Beck‐Coon, K. A., Brown, L. F., ... & Giesler, R. B. (2020). Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: a 3‐arm pilot randomized controlled trial. Cancer, 126(1), 211-218.
  10. Dolbeault, S., Cayrou, S., Bredart, A., Viala, A. L., Desclaux, B., Saltel, P., ... & Dickes, P. (2009). The effectiveness of a psycho‐educational group after early‐stage breast cancer treatment: results of a randomized French study. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 18(6), 647-656.
  11. Siddons, H. M., Wootten, A. C., & Costello, A. J. (2013). A randomised, wait‐list controlled trial: evaluation of a cognitive–behavioural group intervention on psycho‐sexual adjustment for men with localised prostate cancer. Psycho‐oncology, 22(10), 2186-2192.
  12. Targ, E. F., & Levine, E. G. (2002). The efficacy of a mind-body-spirit group for women with breast cancer: a randomized controlled trial. General Hospital Psychiatry, 24(4), 238-248.
  13. Kissane, D. W., Bloch, S., Smith, G. C., Miach, P., Clarke, D. M., Ikin, J., ... & McKenzie, D. (2003). Cognitive‐existential group psychotherapy for women with primary breast cancer: a randomised controlled trial. Psycho‐Oncology: Journal of the Psychological, Social and Behavioral Dimensions of Cancer, 12(6), 532-546.
  14. Liu, C. J., Hsiung, P. C., Chang, K. J., Liu, Y. F., Wang, K. C., Hsiao, F. H., ... & Chan, C. L. (2008). A study on the efficacy of body–mind–spirit group therapy for patients with breast cancer. Journal of Clinical Nursing, 17(19), 2539-2549.
  15. Herschbach, P., Book, K., Dinkel, A., Berg, P., Waadt, S., Duran, G., ... & Henrich, G. (2010). Evaluation of two group therapies to reduce fear of progression in cancer patients. Supportive care in cancer, 18, 471-479.
  16. Forester, B., Kornfeld, D. S., Fleiss, J. L., & Thompson, S. (1993). Group psychotherapy during radiotherapy: effects on emotional and physical distress. The American journal of psychiatry, 150(11), 1700-1706.
  17. Ho, R. T., Fong, T. C., Lo, P. H., Ho, S. M., Lee, P. W., Leung, P. P., ... & Chan, C. L. (2016). Randomized controlled trial of supportive-expressive group therapy and body-mind-spirit intervention for Chinese non-metastatic breast cancer patients. Supportive Care in Cancer, 24, 4929-4937.
  18. Charalambous, A., Kaite, C. P., Charalambous, M., Tistsi, T., & Kouta, C. (2017). The effects on anxiety and quality of life of breast cancer patients following completion of the first cycle of chemotherapy. SAGE open medicine, 5, 2050312117717507.
  19. Fenlon, D., Maishman, T., Day, L., Nuttall, J., May, C., Ellis, M., ... & Hunter, M. S. (2020). Effectiveness of nurse‐led group CBT for hot flushes and night sweats in women with breast cancer: Results of the MENOS4 randomised controlled trial. Psycho‐oncology, 29(10), 1514-1523.
  20. Mansouri, A., Javedani, M., Yazd, S. A. R., Nikandish, M., Khataei, A., Atrian, A., ... & Seifi, Z. (2023). The efficacy of cognitive-behavioral group therapy on depression, anxiety, and pain-coping strategies in women with breast cancer. The Journal of Nervous and Mental Disease, 211(11), 835-840.
  21. Hassani Alimolk, F., McDonald, F. E. J., Asghari‐Jafarabadi, M., Ahmadi, F., Zenoozian, S., Lashkari, M., & Patterson, P. (2024). A randomized clinical trial: Efficacy of group‐based acceptance and commitment therapy program for breast cancer patients with high fear of progression. Psycho‐Oncology, 33(4), e6339.
  22. Qiu, J., Chen, W., Gao, X., Xu, Y., Tong, H., Yang, M., ... & Yang, M. (2013). A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression. Journal of Psychosomatic Obstetrics & Gynecology, 34(2), 60-67.
  23. Rissanen, R., Nordin, K., Ahlgren, J., & Arving, C. (2015). A stepped care stress management intervention on cancer‐related traumatic stress symptoms among breast cancer patients—a randomized study in group vs. individual setting. Psycho‐Oncology, 24(9), 1028-1035.
  24. Peng, W., Zhang, H., & Li, Z. (2019). Responses of lung cancer survivors undergoing gamma knife surgery to supportive group psychotherapy. Medicine, 98(9), e14693.
  25. Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. The lancet oncology, 12(2), 160-174.
  26. Wang, S., Zhu, Y., Wang, Z., Zheng, M., Li, X., Zhang, Y., & Wan, H. (2023). Efficacy of meaning-centered group psychotherapy in Chinese patients with cancer: A randomized controlled trial. Palliative & Supportive Care, 21(5), 773-781.
  27. Wang, J., Yan, C., & Fu, A. (2019). A randomized clinical trial of comprehensive education and care program compared to basic care for reducing anxiety and depression and improving quality of life and survival in patients with hepatocellular carcinoma who underwent surgery. Medicine, 98(44), e17552.
  28. Van der Spek, N., Vos, J., van Uden-Kraan, C. F., Breitbart, W., Cuijpers, P., Holtmaat, K., ... & Verdonck-de Leeuw, I. M. (2017). Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial. Psychological medicine, 47(11), 1990-2001.
  29. Zhang, L., Li, Y., Kou, W., Xia, Y., Yu, X., & Du, X. (2021). Reminiscence therapy exhibits alleviation of anxiety and improvement of life quality in postoperative gastric cancer patients: a randomized, controlled study. Medicine, 100(35), e26821.