Adjustment Disorder Clinical Trial
Official title:
Creating Meaning Following Cancer: An Cognitive-existential Intervention to Improve Existential and Global Quality of Life
The purpose of this study is to test the efficacy of a cognitive-existential intervention (using either an individual or a group format) to improve the existential and global quality of life of patients as compared to usual care in a population of adult non-metastatic cancer patients.
People diagnosed with cancer must learn to cope with loss of meaning and empowerment which
compromises quality of life. Questions regarding "Why me?", along with universal existential
concerns about death, search for meaning, and sense of control over one's life, often
constitute the principal source of overall suffering. Since there is no single and
identifiable cause for cancer, those existential questions are commonly observed among
patients who demand specific interventions to properly address this central issue. The
existential approach can be used to help patients find meaning in the midst of a crisis. It
addresses a central issue of survivorship in cancer.
The conceptual model explains the relation between being exposed to a stressful and traumatic
life event such as cancer and the risk of progressing toward adjustment difficulties which
compromises quality of life and existential integrity. Cancer constitutes a major stressor
involving significant losses that confronts the person's beliefs system. A set of therapeutic
strategies can help to cope with this inevitable challenge: 1) cognitive-behavioral
strategies; 2) direct existential intervention; and 3) social support through
supportive-expressive strategies. Adjustment first involves cognitive reframing of the
perception of the situation (situational meaning). Cognitive reframing also contributes to a
readjustment of personal beliefs and values (global meaning and existential dimension).
Existential strategies enable to further this process by including cognitive (beliefs, sense
of coherence, expectations), motivational (choice, goal setting, and goal driving) and
affective dimensions. The expressive-supportive strategy promotes active listening and
non-judgmental support to encourage expression of emotions. The use of these active coping
strategies (meaning-based) to the threatened-life challenge enables optimization of
existential and global quality of life, as opposed to employing passive strategies such as
avoidance.
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