Sinnzentrierte Psychotherapie in der psychoonkologischen Versorgung

Eine Krebserkrankung kann mit starken emotionalen Belastungen einhergehen. Insbesondere Menschen mit fortgeschrittener Erkrankung berichten über ein breites Spektrum an Symptomen, das unter dem Begriff der existenziellen Belastung zusammengefasst wird. Diese Form der Belastung ist mit Einschränkungen der Lebensqualität bis hin zu Suizidgedanken assoziiert. Sinnzentrierte Psychotherapie ist wirksam hinsichtlich der Reduktion existenzieller Belastung.

Abstract

Being diagnosed with cancer is commonly associated with psychological distress. Especially patients with advanced disease report a range of distinct symptoms that are referred to as existential distress. The conceptualization of existential distress is mainly characterized by the loss of a sense of meaning and purpose in life resulting from the confrontation with a life-threatening disease. Existential distress has a significant impact on health care outcomes and quality of life. It has been found to be associated with suicidal ideation, even in the absence of mental disorders such as depression. Meaning-centered psychotherapy offers effective interventions with regard to reducing existential distress in cancer patients.

Schlüsselwörter

sinnzentrierte Psychotherapie - Psychoonkologie - Existenzielle Belastung

Key words

meaning-centered psychotherapy - psycho-oncology - existential distress

Publication History

Article published online:
30 May 2023

• Literatur

• 1 Erdmann F, Spix C, Katalinic A. et al. Krebs in Deutschland für 2017/2018. Robert Koch-Institut. 2021 Im Internet https://edoc.rki.de/handle/176904/9042;jsessionid=7F5F1FC427DAEF8832AFBDDBF1167FAF; Stand: 05.03.2023
• 2 Mehnert A, Hartung TJ, Friedrich M. et al. One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psychooncology 2018; 27: 75-82 DOI: 10.1002/pon.4464.
• 3 Vehling S, Kissane DW. Existential distress in cancer: Alleviating suffering from fundamental loss and change. Psychooncology 2018; 27: 2525-2530 DOI: 10.1002/pon.4872.
• 4 Breitbart WS. Meaning-Centered Psychotherapy in the Cancer Setting: Finding Meaning and Hope in the Face of Suffering. Oxford: Oxford University Press; 2016
• 5 Kissane DW. The relief of existential suffering. Arch Intern Med 2012; 172: 1501-1505 DOI: 10.1001/archinternmed.2012.3633.
• 6 Philipp R, Kalender A, Härter M. et al. Existential distress in patients with advanced cancer and their caregivers: study protocol of a longitudinal cohort study. BMJ Open 2021; 11: e046351 DOI: 10.1136/bmjopen-2020-046351.
• 7 Robinson S, Kissane DW, Brooker J. et al. A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research. J Pain Symptom Manage 2015; 49: 595-610 DOI: 10.1016/j.jpainsymman.2014.07.008.
• 8 Yalom I. Existentielle Psychotherapie. Köln: Edition Humanistische Psychologie; 1989
• 9 Frankl VE. trotzdem Ja zum Leben sagen: Ein Psychologe erlebt das Konzentrationslager. München: Penguin-Verlag; 2018
• 10 Breitbart W, Pessin H, Rosenfeld B. et al. Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer. Cancer 2018; 124: 3231-3239 DOI: 10.1002/cncr.31539.
• 11 Vehling S, Kissane DW, Lo C. et al. The association of demoralization with mental disorders and suicidal ideation in patients with cancer. Cancer 2017; 123: 3394-3401 DOI: 10.1002/cncr.30749.
• 12 Mehnert-Theuerkauf A, Lehmann-Laue KA. et al. Hrsg. Psychoonkologie in der palliativen Versorgung. Ein Praxishandbuch. Stuttgart: Verlag W. Kohlhammer; 2022
• 13 Bobevski I, Kissane DW, Vehling S. et al. Demoralisation and its link with depression, psychological adjustment and suicidality among cancer patients: A network psychometrics approach. Cancer Med 2022; 11: 815-825 DOI: 10.1002/cam4.4406.
• 14 McFarland DC, Walsh L, Napolitano S. et al. Suicide in Patients With Cancer: Identifying the Risk Factors. Oncology (Williston Park) 2019; 33: 221-226
• 15 Ross S, Agin-Liebes G, Lo S. et al. Acute and Sustained Reductions in Loss of Meaning and Suicidal Ideation Following Psilocybin-Assisted Psychotherapy for Psychiatric and Existential Distress in Life-Threatening Cancer. ACS Pharmacol Transl Sci 2021; 4: 553-562 DOI: 10.1021/acsptsci.1c00020.
• 16 Habermas T, Bluck S. Getting a life: the emergence of the life story in adolescence. Psychol Bull 2000; 126: 748-769 DOI: 10.1037/0033-2909.126.5.748.
• 17 Breitbart W, Poppito SR. Meaning-centered group psychotherapy for patients with advanced cancer. A treatment manual. Oxford: Oxford University Press; 2015
• 18 Rodin G, Hales S. Managing Cancer and Living Meaningfully: An Evidence-Based Intervention for Cancer Patients and Their Caregivers. Oxford: Oxford University Press; 2021
• 19 Reuter K, Spiegel D. Psychische Belastungen bei Krebserkrankungen. Hogrefe; 2015. DOI: 10.1026/02503-000
• 20 Breitbart W, Poppito SR. Individual meaning-centered psychotherapy for patients with advanced cancer. A treatment manual. Oxford: Oxford University Press; 2015
• 21 Rodin G, Lo C, Rydall A. et al. Managing Cancer and Living Meaningfully (CALM): A Randomized Controlled Trial of a Psychological Intervention for Patients With Advanced Cancer. J Clin Oncol 2018; 36: 2422-2432 DOI: 10.1200/JCO.2017.77.1097.
• 22 Mehnert A, Koranyi S, Philipp R. et al. Efficacy of the Managing Cancer and Living Meaningfully (CALM) individual psychotherapy for patients with advanced cancer: A single-blind randomized controlled trial. Psychooncology 2020; 29: 1895-1904 DOI: 10.1002/pon.5521.
• 23 Breitbart W, Poppito S, Rosenfeld B. et al. Pilot Randomized Controlled Trial of Individual Meaning-Centered Psychotherapy for Patients With Advanced Cancer. J Clin Oncol 2012; 30: 1304-1309 DOI: 10.1200/JCO.2011.36.2517.
• 24 Lai J, Song H, Ren Y. et al. Effectiveness of Supportive-Expressive Group Therapy in Women with Breast Cancer: A Systematic Review and Meta-Analysis. Oncol Res Treat 2021; 44: 252-260 DOI: 10.1159/000515756.
• 25 Bauereiß N, Obermaier S, Özünal SE. et al. Effects of existential interventions on spiritual, psychological, and physical well-being in adult patients with cancer: Systematic review and meta-analysis of randomized controlled trials. Psychooncology 2018; 27: 2531-2545 DOI: 10.1002/pon.4829.
• 26 Applebaum AJ, Baser RE, Roberts KE. et al. Meaning-Centered Psychotherapy for Cancer Caregivers: A pilot trial among caregivers of patients with glioblastoma multiforme. Transl Behav Med 2022; 12: 841-852 DOI: 10.1093/tbm/ibac043.
• 27 Roberts KE, Applebaum AJ. The benefits of concurrent engagement in meaning-centered psychotherapy and meaning-centered psychotherapy for cancer caregivers: A case study. Palliat Support Care 2022; 20: 754-756 DOI: 10.1017/S1478951522001109.
• 28 Ghasemi M, Mohammadian Y, Parvizifard AA. et al. The effectiveness of Meaning-Centered Group Psychotherapy on improving spiritual well-being and reducing anxiety in Iranian male cardiovascular patients. J Educ Health Promot 2022; 11: 387 DOI: 10.4103/jehp.jehp_1626_21.
• 29 Polacek LC, Reisch S, Saracino RM. et al. Implementation of a Meaning-Centered Psychotherapy training (MCPT) program for oncology clinicians: a qualitative analysis of facilitators and barriers. Transl Behav Med 2021; 11: 270-275 DOI: 10.1093/tbm/ibz138.