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Support Groups

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, and provide a place for people to share common concerns and emotional support.

Overview

A growing body of research has shown that support groups can enhance quality of life. Available scientific evidence is unclear as to whether 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 say that when they have emotional support, it is easier 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.

What does it involve?

Support groups may include education, behavioral training, and group interaction. People with cancer are often encouraged by health care professionals to seek support from groups of people who have experience 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, and even children with cancer in the family. The format of different groups varies from lectures and discussions to exploration and expression of feelings. Behavioral training can involve muscle relaxation or meditation to reduce stress and cope with the side effects of treatments such as chemotherapy or radiation therapy. Topics addressed 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 professionals 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 online. Participating in an online support group allows people to interact virtually, often by sending and receiving messages whenever they have the time to participate, or during scheduled meeting times. These groups vary widely in quality. Some are led or managed 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 in general believes that support groups can enhance quality of life for many people with cancer. The groups do this by providing information and practical support to manage feelings of isolation 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.

Overall, research reports about the ability of group participation to extend life have been inconsistent. In Dr. Spiegel’s 1989 clinical trial, the group of women with metastatic breast cancer who took part in supportive group therapy lived 18 months longer than women who didn’t. However, a similar study by Dr. Pamela Goodwin found that supportive–expressive group therapy reduced anxiety and perception of pain, but did not influence survival. Several additional studies have tested this idea. Some of these studies found relatively small differences in survival between support group participants and non-participants, whereas others showed no difference at all in survival.

Still, there was a lot of public interest in this topic, and more studies were done. A few of these studies seemed to show small differences in survival between support group participants and non-participants, although most showed no difference at all in survival.

Finally, Spiegel himself tried to repeat the 1989 study in 2007 with a new group to see if the result would be the same as that of their earlier trial. The 2007 study reported better quality of life among those who took part in the group, but there was no difference in survival.

Research has further shown that giving cancer patients information in a support group setting can help reduce tension, anxiety, and tiredness (fatigue), and may lower the risk of depression. A statistical combination of results (known as meta-analysis) from many previous randomized clinical trials of group psychotherapy and psychoeducation that had been completed as of 2010 concluded that although results of individual studies varied somewhat, in general these programs improved the quality of life of cancer patients/survivors and reduced their distress and anxiety.

Some other studies have shown that supporting cancer patients with keeping doctors' appointments and teaching them about their treatment during group meetings may help them follow their treatment plan as well as reduce stress. Patients who are less stressed and less depressed are more likely to keep doctors' appointments and taking cancer treatments as prescribed, and to have positive health behaviors such as good nutrition and physical activity, which tend to improve their prognosis. As stress has been implicated in the functioning of the immune system, it is plausible that reducing emotional distress could impact physical health. While studies are investigating this hypothesis, it remains uncertain is whether support groups and other related forms of psychological support can have “mind-body” effects that influence the growth and spread cancer. Several prominent experts on both sides of this controversy have written articles and presented their views at scientific conferences, without any clear resolution.

In summary, the research is clear that support groups can affect quality of life, but uncertain as to whether support groups or other forms of mental health therapy can help people with cancer live longer. In this era of patient-centered care, it is clear that people with cancer often care not only about the length of their survival but also about the quality of their lives during survivorship. Because of the significant benefits to quality of life, several leading cancer organizations recommend that checking and treating psychological distress should be a routine part of conventional cancer care, regardless of whether there is any impact on survival. Some patients may also reasonably view support groups or other forms of mental health therapy as a complementary therapy that, together with cancer-directed treatments such as surgery, medications, and/or radiation might enhance the survival. However, psychological or psychiatric should not be viewed as an alternative to cancer-directed treatments.

Are there any possible problems or complications?

Support groups vary in quality and focus. People with cancer may find that 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 uncomfortable feelings or because the leader is not skilled enough to manage difficult situations. Rarely, others in support groups might not respect boundaries or follow rules. 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. These are things a person would want to find out about before choosing a support group. There are reputable organizations that manage these issues carefully to help protect participants.

Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

To learn more

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 (1-800-227-2345).

Dietary Supplements: What Is Safe?

The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

References

Andersen BL, Farrar WB, Golden-Kreutz DM, et al. Distress reduction from a psychological intervention contributes to improved health for cancer patients. Brain Behav Immun 2007;21:953-961.

Andersen BL, Yang HC, Farrar WB. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 2008 Dec 15;113(12):3450-8

Boesen EH, Karlsen R, Christensen J, et al. Psychosocial group intervention for patients with primary breast cancer: a randomised trial. Eur J Cancer. 2011 Jun;47(9):1363-1372.

Björneklett HG, Lindemalm C, Rosenblad A, et al. A randomised controlled trial of support group intervention after breast cancer treatment: results on anxiety and depression. Acta Oncol. 2012 Feb;51(2):198-207.

Coyne JC, Stefanek M, Palmer SC. Psychotherapy and survival in cancer: the conflict between hope and evidence. Psychol Bull. 2007 May;133(3):367-394.

Coyne JC, Tennen H. Positive psychology in cancer care: bad science, exaggerated claims, and unproven medicine. Ann Behav Med. 2010 Feb;39(1):16-26.

Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 31 (6): 782-93, 2013.

Giese-Davis J, Collie K, Rancourt KM, Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol 2011; 29:413-420.

Goodwin PJ, Leszcz M, Ennis M, et al. The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med 2001;345:1719-26.

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.

Kissane D. Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer care. Psychooncology. 2009 Jan;18(1):1-5.

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.

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.

Spiegel D, Bloom JR, Kraemer HC, et al: Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2:888-891.

Spiegel D, Butler LD, Giese-Davis J, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer. 2007; 110:1130-1138.

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: 03/20/2015
Last Revised: 03/20/2015