Existential behavioural therapy for informal caregivers of palliative patients: a randomised controlled trial

Psychooncology. 2013 Sep;22(9):2079-86. doi: 10.1002/pon.3260. Epub 2013 Mar 27.

Abstract

Background: Existential behavioural therapy (EBT) was developed to support informal caregivers of palliative patients in the last stage of life and during bereavement as a manualised group psychotherapy comprising six sessions. We tested the effectiveness of EBT on mental stress and quality of life (QOL).

Methods: Informal caregivers were randomly assigned (1:1) to EBT or a treatment-as-usual control group using computer-generated numbers in blocks of 10. Primary outcomes were assessed with the Brief Symptom Inventory (subscales somatisation, anxiety and depression), the Satisfaction with Life Scale (SWLS), the WHOQOL-BREF and a numeric rating scale for QOL (QOL-NRS, range 0-10). Data were collected at baseline, pre-treatment, post-treatment and follow-ups after 3 and 12 months. Treatment effects were assessed with a multivariate analysis of covariance.

Results: Out of 160 relatives, 81 were assigned to EBT and 79 to the control group. Participants were 54.5 ± 13.2 years old; 69.9% were female. The multivariate model was significant for the pre-/post-comparison (p=0.005) and the pre-/12-month comparison (p=0.05) but not for the pre-/3-month comparison. Medium to large effects on anxiety and QOL (SWLS, WHOQOL-BREF, QOL-NRS) were found at post-treatment; medium effects on depression and QOL (QOL-NRS) emerged in the 12-month follow-up. No adverse effects of the intervention were observed.

Conclusion: Existential behavioural therapy appears to exert beneficial effects on distress and QOL of informal caregivers of palliative patients. Further longitudinal evidence is needed to confirm these findings.

Keywords: behavioural therapy; cancer; existential; informal caregivers; oncology; palliative care.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety / prevention & control
  • Anxiety / therapy
  • Behavior Therapy / methods*
  • Bereavement
  • Caregivers / psychology*
  • Depression / prevention & control
  • Depression / therapy
  • Existentialism / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mindfulness / methods
  • Neoplasms / nursing*
  • Palliative Care / psychology*
  • Psychotherapy, Group / methods*
  • Quality of Life
  • Stress, Psychological / prevention & control*
  • Stress, Psychological / therapy
  • Treatment Outcome