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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 support 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. 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. Some support groups are made up of people with the
same type of cancer, while others include people who are having the
same kind of treatment. Support groups are available for patients,
family members, and other caregivers of people who have cancer. The
format of different groups varies from lectures and discussions to
exploration and expression of feelings. Topics discussed in 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, whereas 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 in one of the group
member’s homes.
Support groups also take place on the Internet, and 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, a type of therapeutic group meeting called
an encounter group 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 who have cancer has grown since then. Today, there are many
hospital-based, independent, and national networks of support groups
for people with various types of cancer and other diseases, as well as
for their families.
What is the evidence?
The scientific community believes that support groups can
enhance quality of life for people who have cancer by providing
information and support to overcome feelings of aloneness and
helplessness that sometimes result from a cancer diagnosis. 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.
Overall, research has shown conflicting results about the
ability of group participation to extend life. In Dr.
Spiegel’s 1989 clinical trial, women with metastatic breast
cancer lived eighteen months longer if they had taken part in
supportive group therapy. However, 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 four studies of breast
cancer patients found no relationship between survival and support
groups beyond Dr. Spiegel's study.
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 shown improved quality of life in
support group participants. Although more research is needed to
determine 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.
Online support groups should be used with caution. This venue
cannot always assure privacy or confidentiality, and the people
involved may have no special training or qualifications, especially if
the group takes place in an unmonitored chat room.
Relying on this type of treatment alone and avoiding or
delaying conventional medical care for cancer may have serious health
consequences.
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 found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Azar B. Does group therapy mean longer life? APA Monitor.
1999;30:13-14.
Cunningham AJ, Edmonds CV, Jenkins GP, et al. A randomized
controlled trial of the effects of group psychological therapy on
survival in women with metastatic breast cancer. Psychooncology.
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. Psychooncology.
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;104:2596-2601.
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.
National Institutes of Health. 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.
Penson RT, Talsania SH, Chabner BA, Lynch TJ Jr. Help me help
you: support groups in cancer therapy. Oncologist.
2004:9:217-225.
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: OTA-H-405. Washington, DC: US Government Printing
Office; 1990.
Zabalegui A, Sanchez S, Sanchez PD, Juando C. Nursing and
cancer support groups. J
Adv Nurs. 2005;51:369-381.
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.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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