Sarah Edelman’s research while affiliated with University of Technology Sydney and other places

Reviews the psychological outcomes of studies that evaluated group interventions using a predominantly supportive or psychoeducational approach as well as studies that made direct comparisons between the two approaches. Studies were identified via a computerized CD-ROM search on MedLine, Psych Lit, HealthStar, Current Contents and CINAHL. Criteria for inclusion in the review were group psychological intervention with adult cancer patients, use of psychometrically validated instruments, randomized or case-controlled design, and publication in English since 1960. 15 studies were found to be acceptable. Results show the majority of findings suggest that patients who attend psychoeducational groups experience greater benefits than do those who attend purely supportive groups. However, the authors state that further well-designed research in this area is needed to identify specific patient cohorts that are most likely to benefit from each approach (PsycINFO Database Record (c) 2012 APA, all rights reserved)

There is a common public perception that cancer is at least partly affected by psychological factors. Stress, negative attitudes, and personal crises have been cited as causes of the disease or reasons for its progression, while positive attitudes and relaxation have been suggested as possible cures. In the last two decades, research in the newly emerged field of psycho-oncology has begun to investigate the possibility of such a relationship. There is some evidence that factors such as helplessness, hopelessness, emotional suppression, and social isolation may be associated with a higher incidence of cancer onset and poorer survival outcome. However, the large number of contradictory findings, and frequent methodological weaknesses within the research, make these findings inconclusive.

There is a widely held perception that cancer is influenced by psychological factors, and that both the onset and progression of the disease are affected by factors such as stress, depression, social isolation and coping style. This article reviews the evidence for the mind-cancer link. Although hundreds of studies have reported on this issue, much of the research has been undermined by methodological weaknesses such as small sample size and failure to control for confounding factors. Many studies have failed to find any association between psychological factors and cancer, and findings of even the high quality studies have been inconsistent. To date there is insufficient evidence to conclude that psychological factors play a significant and direct role in disease processes in cancer.

The view that psychological factors play a role in the onset and progression of cancer has been promoted widely in the popular media. The present study assessed the prevalence of this view. The respondents- 527 members of the public, 239 cancer patients, and 117 medical practitioners working in oncology-completed a survey questionnaire consisting of three questions in a yes/no format on whether they believed psychological factors can affect the cause, progression, and cure of cancer. Each question was followed by a Likert-scale question asking respondents to estimate the strength of such an effect. The majority of respondents in the public sample endorsed the proposition that psychological factors affect cause (60%), progression (71%), and cure (72%). A larger proportion of patients endorsed the proposition for progression (85%) and cure (86%). Oncologists were less likely to endorse it for cause (12%) and cure (26%). These relationships also held for estimates of the strength of the effect. In the public sample, females and respondents with a university education provided higher estimates of the effects of psychological factors on cancer. These differences were not evident in the patient sample. Given that the scientific evidence to support the "mind-cancer" view is equivocal, the question of whether these perceptions should be challenged needs to be addressed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Cancer support groups have become increasingly available to patients over the last two decades. Although the various patient groups differ in their philosophy, membership, and aims, the majority can be categorized as predominantly “supportive” or “psychoeduca-tional” in their approach. To date, there is little evidence regarding the relative benefits of the two types of group in improving patients' psychological outcomes. This article presents a critical review of the evidence for the relative efficacy of the two approaches. A search of the literature using CD-ROM databases identified 15 studies of acceptable design that quantitatively evaluated psychological outcomes of one or both types of group intervention. Although some findings have been inconsistent, the majority of evidence suggests that patients who attend psychoeducational groups experience greater benefits than do those who attend purely supportive groups. Further well-designed research in this area is needed to identify specific patient cohorts that are most likely to benefit from each approach.

Group CBT programs are widely used for assisting teenagers with anxiety, depression and other psychological problems. The majority of reported programs have targeted school or clinical populations, however, few have specifically targeted adolescents from highly troubled and disadvantaged backgrounds. This paper describes a group CBT program that was developed for teenagers who have not responded well to the formal structures of school and traditional models of classroom management. Problems such as low levels of motivation, poor attention span, learning difficulties, poor impulse control, substance abuse, and other mental health problems are common within this population. A number of challenges arose in running the program and several modifications were made in order to make it more relevant to participants. These changes resulted in more rapid engagement with the program, improved cooperation within the group, fewer interruptions, and improved rapport. The clinical outcomes associated with the program could not be measured due to difficulties with completing administering self-report questionnaires.

It is well established that some individuals have an inherent disposition toward experiencing anxiety more readily than others. These individuals are prone to high levels of autonomic arousal, exaggerated threat perception and dysfunctional coping strategies. In general practice these patients present frequently with a broad range of physical and psychological concerns that are often time consuming and challenging for general practitioners to assess and manage. In this article we suggest some management strategies based on a cognitive behavioural therapy approach. Cognitive behavioural therapy strategies such as cognitive reframing, behavioural experiments and graded exposure have been shown to be effective in the treatment of anxiety. We also present some examples and worksheets to illustrate how these techniques can be applied in general practice.

Forty-nine patients scheduled for implantable cardioverter defibrillator (ICD) implantation completed self-report psychological questionnaires prior to surgery and at 2, 4 and 6 months after surgery. The most common psychological problem identified was anxiety, with clinically significant cases based on the Depression Anxiety and Stress Scale (DASS) ranging between 26% and 34%. Clinically significant depression ranged between 8% and 20%. Anxiety sensitivity was associated with high levels of anxiety, depression and stress at baseline, but not at follow-up assessments. It is possible that within this population anxiety sensitivity is associated with distress during high-threat situations, but the relationship diminishes once the threat has passed. In addition, the reassurance provided by the ICD may reduce negative perceptions of symptoms, promoting psychological adaptation.

The aim of this pilot study was to evaluate the feasibility of a brief educational intervention administered two weeks after Automatic Implantable Cardioverter Defibrillator (AICD) implantation on subsequent levels of anxiety, depression, stress and hostility. A randomised controlled design was used. Twenty-two patients hospitalised for implantation of an AICD were recruited for the study. Thirteen patients were randomised to attend the intervention and nine to the standard care control group. The educational intervention was delivered by a nurse and psychologist. It comprised one 60-90 minute session in which the patient and a significant other received detailed information about the AICD (including practical and psychological aspects), and had the opportunity to ask questions, express concerns and receive reassurance. The DASS was used to measure anxiety, depression and stress at two, four and six months after AICD insertion. Patients who attended the intervention showed no significant improvements or trend toward improvement on any of the measured psychological domains. The findings suggest that a single educational session delivered to recent AICD recipients is not sufficient to improve patients' psychological adjustment.

Twenty-five patients who had attended a group cognitive behavior therapy program for breast cancer patients were interviewed by telephone about their experience. Responses were categorized independently and indicated that participants enjoyed the interpersonal and social environment of the group, but also acknowledged the benefits provided by the cognitive behavior therapy modality of the group. While the majority of groups that are currently run for cancer patients are supportive, it is possible that adding a psycho-educational component may meet the needs of greater number of patients.