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Other common name(s): Group Therapy, Group Psychotherapy, Psychosocial Interventions, Psychosocial Treatment
Scientific/medical name(s): None
Description
Support groups present information, provide comfort, teach coping skills, help reduce anxiety, and provide a place for people to share common concerns and emotional support.
Overview
Preliminary research has shown that many groups can enhance quality of life. Available scientific evidence does not support claims that support groups can actually extend the survival time of people with cancer.
How is it promoted for use?
People who take part in support groups believe that they can live healthier, happier lives if they spend time relating to others. They believe that when relatives and friends lend support, it is easier for people to deal with their health and social problems. Some claim that the bonds formed between members of support groups help them feel stronger. They further claim that sharing feelings and experiences within support groups can reduce stress, fear, and anxiety and help to promote healing. Evidence suggests that support groups can improve quality of life for people with cancer.
What does it involve?
Support groups may include education, behavioral training, and group interaction. Behavioral training can involve muscle relaxation or meditation to reduce stress or the effects of chemotherapy or radiation therapy (see Meditation). People with cancer are often encouraged by health care professionals to seek support from groups of people who have direct or indirect experiences with the same type of cancer.
Many different kinds of support groups are available and they vary in their structure and activities. Some are time-limited, while others are ongoing. There are also support groups made up of people with the same type of cancer, while others are include people who are having the same kind of treatment. Support groups are available for patients, family members, and other caregivers of people with cancer. The format of different groups varies from lectures and discussions to exploration and expression of feelings. Topics discussed by support groups are those of concern to the members and those the group leader thinks are important.
Support groups are different from group therapy. Support groups may be led by survivors, group members, or trained professionals, while therapy groups are always facilitated by licensed counselors such as marriage and family therapists, nurses, psychologists, psychiatrists, and social workers. Group therapy is generally longer, more involved, and focuses on in-depth personal growth (see Psychotherapy). Support groups focus on learning to manage current concerns and situations. Most support groups involve little or no cost to the participants, while there is usually a fee for group therapy. Support group meetings can be held in hospitals, school classrooms, community centers, office buildings, or one of the group member's homes.
Some support groups also take place on the Internet. They usually involve interacting with people by sending and receiving messages via computer. These groups vary widely in quality. Some are led by moderators in chat-rooms or on e-mail lists, while others are not moderated.
What is the history behind it?
In the late 1970s, encounter groups became popular, and group-intervention studies began appearing in a variety of science journals. An influential study by Dr. David Spiegel in 1989 reported that group therapy helped women with breast cancer to cope and live longer. The demand for support groups from people with cancer has grown since then. Today, there are many hospital-based, independent, and national networks of support groups for people with various forms of cancer and other diseases, as well as for their families.
What is the evidence?
The scientific community believes that support groups can enhance the quality of life for people with cancer by providing information and support to overcome the feelings of aloneness and helplessness that sometimes result from a diagnosis of cancer. Research has shown that people with cancer are better able to deal with their disease when supported by others in similar situations.
One clinical trial found that support groups helped in reducing tension, anxiety, fatigue, and confusion. Some research has shown that there is a link between group support and greater tolerance of cancer treatment and treatment compliance. One psychologist found that an educational, supportive intervention resulted in more patients taking their medicines as prescribed, which led to an increase in survival rates.
The 1989 clinical trial by Dr. Spiegel reported that women with metastatic breast cancer lived 18 months longer if they had taken part in supportive group therapy. Scientists later realized that his study had used average survival rather than median survival to compare the groups. Average survival can be greatly changed by one early death or one long-term survivor, so it can be quite misleading. Another clinical trial found no significant difference in survival between breast cancer patients who took part in group therapy and those who did not. Yet another clinical trial found that patients with malignant melanoma lived longer if they had taken part in a group psycho-educational course. A 2005 review of 4 studies of breast cancer patients found no relationship between survival and support groups beyond Dr. Spiegel's study. Overall, research has shown conflicting results about the ability of group participation to extend life.
One study at the Ontario Cancer Institute found that women with breast cancer who lacked support from families and friends were helped the most by support groups. Researchers at Carnegie Mellon University recently found that educational groups helped women adjust to a diagnosis of early stage breast cancer. However, they also found there were some negative effects from group discussion. Some of the women in the group who were already getting support at home gained no benefit from the group.
In summary, randomized clinical trials have shown inconsistent effects on survival, but most have reported improved quality of life in support group participants. Although more research is needed to find out what types of groups are most effective with what type of people, support groups may be useful as a complementary therapy for people with cancer and other diseases.
Are there any possible problems or complications?
Support groups vary in quality and focus. People with cancer may find the support group they have joined does not discuss topics of interest to them. Some people may find a support group upsetting because it stirs up too many uncomfortable feelings or because the leader is not skilled enough. Information that is shared in some groups may not always be reliable.
Support groups that are on the Internet should be used with caution. This method cannot always assure privacy or confidentiality, and the people involved may have no special training or qualifications, especially if found in unmonitored chat rooms.
Additional Resources
More Information from Your American Cancer Society
The following information on complementary and alternative therapies may also be helpful to you. These materials may be ordered from our toll-free number (1-800-ACS-2345).
References
Alternative Medicine: Expanding Medical Horizons. A Report to the National Institutes of Health on Alternative Medical Systems and Practices in the United States. Washington, DC: US Government Printing Office; 1994. NIH publication 94-066.
Azar B. Does group therapy mean longer life? APA Monitor. 1999;30:13-14.
Cunningham AJ, Edmonds CV, Jenkins GP, Pollack H, Lockwood GA, Warr D. A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psycho-Oncology. 1998;7:508-517.
Edmonds CV, Lockwood GA, Cunningham AJ. Psychological response to long-term group therapy: a randomized trial with metastatic breast cancer patients. Psycho-Oncology. 1999;8:74-91.
Fawzy FI, Fawzy NW, Arndt LA, Pasnau RO. Critical review of psychosocial interventions in cancer care. Arch Gen Psychiatry. 1995;52:100-113.
Goodwin PJ. Support groups in advanced breast cancer. Cancer. 2005 Dec 1;104(11 Suppl):2596-601
Helgeson VS, Cohen S, Schulz R, Yasko J. Education and peer discussion group interventions and adjustment to breast cancer. Arch Gen Psychiatry. 1999;56:340-347.
Kogon MM, Biswas A, Pearl D, Carlson RW, Spiegel D. Effects of medical and psychotherapeutic treatment on the survival of women with metastatic breast carcinoma. Cancer. 1997;80:225-230.
Penson RT, Talsania SHG, Chabner BA, Lynch Jr. TJ. Help Me Help You: Support Groups in Cancer Therapy. The Oncologist; 2004: 9(2): 217–225
Richardson JL, Shelton DR, Krailo M, Levine AM. The effect of compliance with treatment on survival among patients with hematologic malignancies. J Clin Oncol. 1990;8:356-364.
US Congress, Office of Technology Assessment. Unconventional Cancer Treatments. Washington, DC: US Government Printing Office; 1990. Publication OTA-H-405.
Zabalegui A, Sanchez S, Sanchez PD, Juando C. Nursing and cancer support groups. J Adv Nurs. 2005 Aug;51(4):369-81.
Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.
Revised: 03/26/2007
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