Meaning and Purpose (MaP) therapy II: Feasibility and acceptability from a pilot study in advanced cancer

David W. Kissane, Carolyn Lethborg, Joanne Brooker, Courtney Hempton, Sue Burney, Natasha Michael, Margaret Staples, Tanya Osicka, Merlina Sulistio, Jeremy Shapiro, Hilary Hiscock

Research output: Contribution to journalArticleResearchpeer-review

Abstract

OBJECTIVE:
Meaning and Purpose (MaP) therapy aims to enhance meaning-based coping through a life review that focuses on the value and worth of the person, key relationships, sources of fulfillment, roles, and future priorities in living life out fully. We sought to test the feasibility and acceptability of a six-session model of MaP therapy against a wait-list control cohort in a pilot study seeking effect sizes on measures of adaptation.

METHOD:
We randomized patients with advanced cancer to MaP therapy or wait-list control, with measures administered at baseline and after 6-8 weeks. Wait-list patients could then crossover to receive therapy, with further measures collected postintervention. Adherence to the manualized model was sustained through weekly supervision and fidelity coding of recorded sessions. We used generalized estimating equations to control for baseline and any correlation of data.ResultFrom 134 eligible participants, 57 (43%) consented, and 40 of 45 (89%) offered therapy completed 6 sessions. Key barriers to consenting patients were poor health (15 refusers and 4 withdrawals) and death intervened in 6 participants. MaP therapy generated adequate effect sizes in posttraumatic growth (new possibilities, appreciation of life, and personal strength) and life attitudes (choices and goal seeking) to permit calculation of power for a formal randomized, controlled trial.Significance of resultsDelivery of this model of existentially oriented therapy is feasible and acceptable to patients. A properly powered randomized controlled trial is justified to examine the efficacy of this intervention.
Original languageEnglish
Pages (from-to)21-28
Number of pages8
JournalPalliative and Supportive Care
Volume17
Issue number1
DOIs
Publication statusPublished - Feb 2019

Keywords

  • Meaning-centered therapy
  • Demoralization
  • Existential
  • Fulfillment
  • Hope
  • Posttraumatic growth
  • Purpose-in-life
  • Relational meaning
  • Role
  • Self-worth

Cite this

Kissane, David W. ; Lethborg, Carolyn ; Brooker, Joanne ; Hempton, Courtney ; Burney, Sue ; Michael, Natasha ; Staples, Margaret ; Osicka, Tanya ; Sulistio, Merlina ; Shapiro, Jeremy ; Hiscock, Hilary. / Meaning and Purpose (MaP) therapy II: Feasibility and acceptability from a pilot study in advanced cancer. In: Palliative and Supportive Care. 2019 ; Vol. 17, No. 1. pp. 21-28.
@article{150fb433214e43398d62155393cde394,
title = "Meaning and Purpose (MaP) therapy II: Feasibility and acceptability from a pilot study in advanced cancer",
abstract = "OBJECTIVE:Meaning and Purpose (MaP) therapy aims to enhance meaning-based coping through a life review that focuses on the value and worth of the person, key relationships, sources of fulfillment, roles, and future priorities in living life out fully. We sought to test the feasibility and acceptability of a six-session model of MaP therapy against a wait-list control cohort in a pilot study seeking effect sizes on measures of adaptation.METHOD:We randomized patients with advanced cancer to MaP therapy or wait-list control, with measures administered at baseline and after 6-8 weeks. Wait-list patients could then crossover to receive therapy, with further measures collected postintervention. Adherence to the manualized model was sustained through weekly supervision and fidelity coding of recorded sessions. We used generalized estimating equations to control for baseline and any correlation of data.ResultFrom 134 eligible participants, 57 (43{\%}) consented, and 40 of 45 (89{\%}) offered therapy completed 6 sessions. Key barriers to consenting patients were poor health (15 refusers and 4 withdrawals) and death intervened in 6 participants. MaP therapy generated adequate effect sizes in posttraumatic growth (new possibilities, appreciation of life, and personal strength) and life attitudes (choices and goal seeking) to permit calculation of power for a formal randomized, controlled trial.Significance of resultsDelivery of this model of existentially oriented therapy is feasible and acceptable to patients. A properly powered randomized controlled trial is justified to examine the efficacy of this intervention.",
keywords = "Meaning-centered therapy, Demoralization, Existential, Fulfillment, Hope, Posttraumatic growth, Purpose-in-life, Relational meaning, Role, Self-worth",
author = "Kissane, {David W.} and Carolyn Lethborg and Joanne Brooker and Courtney Hempton and Sue Burney and Natasha Michael and Margaret Staples and Tanya Osicka and Merlina Sulistio and Jeremy Shapiro and Hilary Hiscock",
year = "2019",
month = "2",
doi = "10.1017/S1478951518000883",
language = "English",
volume = "17",
pages = "21--28",
journal = "Palliative and Supportive Care",
issn = "1478-9515",
publisher = "Cambridge University Press",
number = "1",

}

Meaning and Purpose (MaP) therapy II: Feasibility and acceptability from a pilot study in advanced cancer. / Kissane, David W.; Lethborg, Carolyn; Brooker, Joanne; Hempton, Courtney; Burney, Sue; Michael, Natasha; Staples, Margaret; Osicka, Tanya ; Sulistio, Merlina; Shapiro, Jeremy; Hiscock, Hilary.

In: Palliative and Supportive Care, Vol. 17, No. 1, 02.2019, p. 21-28.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Meaning and Purpose (MaP) therapy II: Feasibility and acceptability from a pilot study in advanced cancer

AU - Kissane, David W.

AU - Lethborg, Carolyn

AU - Brooker, Joanne

AU - Hempton, Courtney

AU - Burney, Sue

AU - Michael, Natasha

AU - Staples, Margaret

AU - Osicka, Tanya

AU - Sulistio, Merlina

AU - Shapiro, Jeremy

AU - Hiscock, Hilary

PY - 2019/2

Y1 - 2019/2

N2 - OBJECTIVE:Meaning and Purpose (MaP) therapy aims to enhance meaning-based coping through a life review that focuses on the value and worth of the person, key relationships, sources of fulfillment, roles, and future priorities in living life out fully. We sought to test the feasibility and acceptability of a six-session model of MaP therapy against a wait-list control cohort in a pilot study seeking effect sizes on measures of adaptation.METHOD:We randomized patients with advanced cancer to MaP therapy or wait-list control, with measures administered at baseline and after 6-8 weeks. Wait-list patients could then crossover to receive therapy, with further measures collected postintervention. Adherence to the manualized model was sustained through weekly supervision and fidelity coding of recorded sessions. We used generalized estimating equations to control for baseline and any correlation of data.ResultFrom 134 eligible participants, 57 (43%) consented, and 40 of 45 (89%) offered therapy completed 6 sessions. Key barriers to consenting patients were poor health (15 refusers and 4 withdrawals) and death intervened in 6 participants. MaP therapy generated adequate effect sizes in posttraumatic growth (new possibilities, appreciation of life, and personal strength) and life attitudes (choices and goal seeking) to permit calculation of power for a formal randomized, controlled trial.Significance of resultsDelivery of this model of existentially oriented therapy is feasible and acceptable to patients. A properly powered randomized controlled trial is justified to examine the efficacy of this intervention.

AB - OBJECTIVE:Meaning and Purpose (MaP) therapy aims to enhance meaning-based coping through a life review that focuses on the value and worth of the person, key relationships, sources of fulfillment, roles, and future priorities in living life out fully. We sought to test the feasibility and acceptability of a six-session model of MaP therapy against a wait-list control cohort in a pilot study seeking effect sizes on measures of adaptation.METHOD:We randomized patients with advanced cancer to MaP therapy or wait-list control, with measures administered at baseline and after 6-8 weeks. Wait-list patients could then crossover to receive therapy, with further measures collected postintervention. Adherence to the manualized model was sustained through weekly supervision and fidelity coding of recorded sessions. We used generalized estimating equations to control for baseline and any correlation of data.ResultFrom 134 eligible participants, 57 (43%) consented, and 40 of 45 (89%) offered therapy completed 6 sessions. Key barriers to consenting patients were poor health (15 refusers and 4 withdrawals) and death intervened in 6 participants. MaP therapy generated adequate effect sizes in posttraumatic growth (new possibilities, appreciation of life, and personal strength) and life attitudes (choices and goal seeking) to permit calculation of power for a formal randomized, controlled trial.Significance of resultsDelivery of this model of existentially oriented therapy is feasible and acceptable to patients. A properly powered randomized controlled trial is justified to examine the efficacy of this intervention.

KW - Meaning-centered therapy

KW - Demoralization

KW - Existential

KW - Fulfillment

KW - Hope

KW - Posttraumatic growth

KW - Purpose-in-life

KW - Relational meaning

KW - Role

KW - Self-worth

U2 - 10.1017/S1478951518000883

DO - 10.1017/S1478951518000883

M3 - Article

VL - 17

SP - 21

EP - 28

JO - Palliative and Supportive Care

JF - Palliative and Supportive Care

SN - 1478-9515

IS - 1

ER -