Abstract
Purpose of Review
Breast cancer survivors (BCS) often experience psychological problems and lowered quality of life (QOL). While helpful, psychotherapy is often costly and inaccessible. This review aims to provide practitioners with the latest information on empirically tested interventions among BCS that may be used in lieu of, or in addition to, traditional psychotherapy.
Recent Findings
Recent developments in cancer-related psychological interventions include a focus on facilitating emotional disclosure (e.g., expressive writing), enhancing close relationships (e.g., couples-based interventions), and increasing feasibility and accessibility via online and computer-based intervention programs. These alternatives to psychotherapy offer a number of benefits including cost-effectiveness, personalized adaptability, and ease of implementation.
Summary
Utilizing these interventions as alternatives or supplements to traditional psychotherapy may offer BCS an opportunity to increase their QOL, improve psychosocial outcomes, and find meaning in their cancer experience. Choosing the appropriate intervention requires understanding the unique circumstances for each survivor and their family.
Similar content being viewed by others
References
DeSantis C, Ma J, Bryan L, Jemal A. Breast cancer statistics, 2013. CA Cancer J Clin. 2014;64:52–62.
Bower JE, Ganz PA, Desmond KA, et al. Fatigue in long-term breast carcinoma survivors. Cancer. 2006;106:751–8.
Kaltenthaler E, Shackley P, Stevens K, et al.: A systematic review and economic evaluation of computerised cognitive behaviour therapy for depression and anxiety. 2002.
Council NR: From cancer patient to cancer survivor: lost in transition: National Academies Press, 2005.
de Moor JS, Moyé L, Low D, et al. Expressive writing as a presurgical stress management intervention for breast cancer patients. J Soc Integr Oncol. 2008;6
Pennebaker JW, Beall SK. Confronting a traumatic event: toward an understanding of inhibition and disease. J Abnorm Psychol. 1986;95:274.
Gellaitry G, Peters K, Bloomfield D, Horne R. Narrowing the gap: the effects of an expressive writing intervention on perceptions of actual and ideal emotional support in women who have completed treatment for early stage breast cancer. Psycho-Oncology. 2010;19:77–84.
Henry EA, Schlegel RJ, Talley AE, Molix LA, Bettencourt B: The feasibility and effectiveness of expressive writing for rural and urban breast cancer survivors. oncology nursing forum: 2010.
Stanton AL, Danoff-Burg S, Sworowski LA, et al. Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol. 2002;20:4160–8.
Baikie KA, Geerligs L, Wilhelm K. Expressive writing and positive writing for participants with mood disorders: an online randomized controlled trial. J Affect Disord. 2012;136:310–9.
Frattaroli J. Experimental disclosure and its moderators: a meta-analysis. Psychol Bull. 2006;132:823.
Frisina PG, Borod JC, Lepore SJ. A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. J Nerv Ment Dis. 2004;192:629–34.
Burton CM, King LA. Effects of (very) brief writing on health: the two-minute miracle. Br J Health Psychol. 2008;13:9–14.
Low CA, Stanton AL, Bower JE, Gyllenhammer L. A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. Health Psychol. 2010;29:460.
Sohl SJ, Dietrich MS, Wallston KA, Ridner SH. A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema. Psychol Health. 2017;32:826–42.
Wong-Kim E, Sun A, Merighi JR, Chow EA. Understanding quality-of-life issues in Chinese women with breast cancer: a qualitative investigation. Cancer Control. 2005;12:6–12.
Lu Q, Wong CCY, Gallagher MW, et al. Expressive writing among Chinese American breast cancer survivors: a randomized controlled trial. Health Psychol. 2017;36:370.
Stroebe M, Stroebe W, Schut H, Zech E, van den Bout J. Does disclosure of emotions facilitate recovery from bereavement? Evidence from two prospective studies. Journal of consulting and clinical psychology. 2002;70:169.
Jensen-Johansen MB, Christensen S, Valdimarsdottir H, et al. Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors—results from a nationwide randomized clinical trial. Psycho-Oncology. 2013;22:1492–500.
Guastella AJ, Dadds MR. Cognitive-behavioural emotion writing tasks: a controlled trial of multiple processes. J Behav Ther Exp Psychiatry. 2008;39:558–66.
Low CA, Stanton AL, Danoff-Burg S. Expressive disclosure and benefit finding among breast cancer patients: mechanisms for positive health effects. Health Psychol. 2006;25:181.
Wakelin K, Street AF. An online expressive writing group for people affected by cancer: a virtual third place. Aust Soc Work. 2015;68:198–211.
Brandão T, Schulz MS, Matos PM. Psychological intervention with couples coping with breast cancer: a systematic review. Psychol Health. 2014;29:491–516.
Moreira H, Canavarro MC. Psychosocial adjustment and marital intimacy among partners of patients with breast cancer: a comparison study with partners of healthy women. J Psychosoc Oncol. 2013;31:282–304.
Shields CG, Rousseau SJ. A pilot study of an intervention for breast cancer survivors and their spouses. Fam Process. 2004;43:95–107.
Naaman S, Radwan K, Johnson S. Coping with early breast cancer: couple adjustment processes and couple-based intervention. Psychiatry: Interpersonal and Biological Processes. 2009;72:321–45.
Kayser K, Feldman BN, Borstelmann NA, Daniels AA. Effects of a randomized couple-based intervention on quality of life of breast cancer patients and their partners. Soc Work Res. 2010;34:20–32.
Wiesenthal NL: Posttraumatic growth in a cognitive behavioral couple intervention for women with early stage breast cancer. ProQuest Information & Learning: 2006.
Manne SL, Siegel SD, Heckman CJ, Kashy DA. A randomized clinical trial of a supportive versus a skill-based couple-focused group intervention for breast cancer patients. J Consult Clin Psychol. 2016;84:668.
Blais M-C, Maunsell E, Grenier S, et al. Validating the content of a brief informational intervention to empower patients and spouses facing breast cancer: perspectives of both couple members. J Cancer Surviv. 2014;8:508–20.
Carson JW, Carson KM, Gil KM, Baucom DH. Mindfulness-based relationship enhancement. Behav Ther. 2004;35:471–94.
Carlson LE, Doll R, Stephen J, et al. Randomized controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Oncol. 2013;31:3119–26.
Johnston D. Mindfulness: a proposed couple-based intervention for the altered self-identity of breast cancer survivors. Mindfulness. 2012;3:282–90.
Finfgeld DL. Therapeutic groups online: the good, the bad, and the unknown. Issues in mental health nursing. 2000;21:241–55.
Leykin Y, Thekdi SM, Shumay DM, et al. Internet interventions for improving psychological well-being in psycho-oncology: review and recommendations. Psycho-Oncology. 2012;21:1016–25.
Owen JE, Klapow JC, Roth DL, et al. Randomized pilot of a self-guided internet coping group for women with early-stage breast cancer. Ann Behav Med. 2005;30:54–64.
Yun YH, Lee KS, Kim Y-W, et al. Web-based tailored education program for disease-free cancer survivors with cancer-related fatigue: a randomized controlled trial. J Clin Oncol. 2012;30:1296–303.
Ruland CM, Andersen T, Jeneson A, et al. Effects of an internet support system to assist cancer patients in reducing symptom distress: a randomized controlled trial. Cancer Nurs. 2013;36:6–17.
Winzelberg AJ, Classen C, Alpers GW, et al. Evaluation of an internet support group for women with primary breast cancer. Cancer. 2003;97:1164–73.
Schover LR, Canada AL, Yuan Y, et al. A randomized trial of internet-based versus traditional sexual counseling for couples after localized prostate cancer treatment. Cancer. 2012;118:500–9.
DuBenske LL, Gustafson DH, Namkoong K, et al. CHESS improves cancer caregivers’ burden and mood: results of an eHealth RCT. Health Psychol. 2014;33:1261.
Northouse L, Schafenacker A, Barr KL, et al. A tailored web-based psycho-educational intervention for cancer patients and their family caregivers. Cancer Nurs. 2014;37:321.
Fergus K, Ahmad S, McLeod DL, et al. Couplelinks—an online intervention for young women with breast cancer and their male partners: study protocol for a randomized controlled trial. Trials. 2015;16:33.
Deimling GT, Bowman KF, Sterns S, Wagner LJ, Kahana B. Cancer-related health worries and psychological distress among older adult, long-term cancer survivors. Psycho-Oncology. 2006;15:306–20.
Mehnert A, Berg P, Henrich G, Herschbach P. Fear of cancer progression and cancer-related intrusive cognitions in breast cancer survivors. Psycho-Oncology. 2009;18:1273–80.
Lebel S, Tomei C, Feldstain A, Beattie S, McCallum M. Does fear of cancer recurrence predict cancer survivors’ health care use? Support Care Cancer. 2013;21:901–6.
Otto AK, Szczesny EC, Soriano EC, Laurenceau J-P, Siegel SD. Effects of a randomized gratitude intervention on death-related fear of recurrence in breast cancer survivors. Health Psychol. 2016;35:1320.
Simard S, Thewes B, Humphris G, et al. Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv. 2013;7:300–22.
Cleary EH, Stanton AL. Mediators of an Internet-based psychosocial intervention for women with breast cancer. Health Psychol. 2015;34:477.
Stanton AL, Thompson EH, Crespi CM, Link JS, Waisman JR. Project connect online: randomized trial of an internet-based program to chronicle the cancer experience and facilitate communication. J Clin Oncol. 2013;31:3411–7.
Funding
Preparation of the manuscript was supported by a grant from the National Heart, Lung, and Blood Institute (R01HL127260-01) to C. P. Fagundes
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Christopher P. Fagundes has received a grant from the National Heart, Lung, and Blood Institute (R01HL127260-01).
Angie S. LeRoy, Allison Shields, Michelle A. Chen, and Ryan L. Brown declare that they have no competing interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Psycho-Oncology and Supportive Care
Rights and permissions
About this article
Cite this article
LeRoy, A.S., Shields, A., Chen, M.A. et al. Improving Breast Cancer Survivors’ Psychological Outcomes and Quality of Life: Alternatives to Traditional Psychotherapy. Curr Breast Cancer Rep 10, 28–34 (2018). https://doi.org/10.1007/s12609-018-0266-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12609-018-0266-y