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Value of Short term Psychotherapy

Posted 1/8/2014

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  I love this study. It is so completely wonderful to read something that supports what I have believed in and tried to deliver for the past three decades. Not a surprise finding, but this recent study from Germany indicates that short-term psychotherapy reduces depression and anxiety and improves QOL (quality of life) in women with breast cancer. We knew that.

  Here are some of the things I have learned over a long career devoted mostly to working with women who have breast cancer:

1. A diagnosis of cancer is a crisis and no one is at her best in those first weeks. It is a mistake to assess someone's "normal" mood or functioning based on her presentation shortly after diagnosis.

2. Over a surprisingly short period of time, after a medical consultations are completed, and a treatment plan has been developed and begun, almost everyone feels better. Let me be clear: this is still a very tough time emotionally and physically, but it is almost always easier than were the first weeks.

3. Short term psychotherapy focused on support, understanding of the individual's unique situation, bolstering coping, reinforcing appropriate and normal intense feelings, and reducing the sense of isolation will help.

4. Of course, many women can get through this without working with a therapist or attending a support group,but for most people, using these available support systems will help and are an indication of strength.

 If you are interested in more, here is the abstract from the German study. If you want to see the whole study, email me, and I will be happy to send it along.

Efficacy of short-term psychodynamic psychotherapy (STPP) with depressed breast cancer patients: results of a randomized controlled multicenter trial
M. E. Beutel1,†, G. Weißflog2,†*, K. Leuteritz2, J. Wiltink1, A. Haselbacher1, C. Ruckes3, S. Kuhnt2,
Y. Barthel2, B. H. Imruck1, R. Zwerenz1,‡ & E. Brähler2,‡

Background: There is a lack of trials of psychodynamic treatments of depression in breast cancer patients. The
purpose of this trial was to determine the efficacy of short-term psychodynamic psychotherapy (STPP) in non-metastatic breast cancer patients diagnosed with depression, one of the most frequent mental comorbidities of breast cancer.
Patients and methods: In a multicenter prospective trial, 157 breast cancer patients with comorbid depression were randomized to either individual STPP (intervention group, N = 78) or ‘treatment as usual’ (control group, TAU, N = 79). As our primary outcome measure, we hypothesized a higher rate of remission defined as no diagnosis of depression (Structured Clinical Interview for DSM-IV) and reduction in depression score by at least 2 points (Hospital Anxiety and Depression Scale, HADS-D) in STPP versus TAU at treatment termination. Secondary outcomes mainly refer to quality of life (QoL).
Results: In the intention to treat (ITT) analysis, 44% of the STPP group achieved highly significantly more remission than TAU (23%). STPP treatment (OR = 7.64; P < 0.001) was the strongest predictor for remission post-treatment; time was also significant (OR = 0.96; P < 0.05). A high effect favoring STPP (d = 0.82) was observed for the HADS-D score posttreatment (secondary outcome). Regarding further secondary outcomes (QoL), analyses of covariance yielded main effects for group (favoring STPP with an effect size of at least d = 0.5) for global QoL, role, emotional and social functioning, pain, treatment side-effects, breast symptoms and upset by hair loss.
Conclusions: STPP is an effective treatment of a broad range of depressive conditions in breast cancer patients improving depression and functional QoL. Findings are limited by the drop-out rate (∼1/3) and delayed post-treatment assessments.
Future trials may consider stepped-care approaches, tailored to patients’ needs and requirements in the acute
treatment phase.


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