Boesen, E.H., Karlsen, R., Christensen, J., Paaschburg, B., Nielsen, D., Bloch, I.S., . . . Johansen, C. (2011). Psychosocial group intervention for patients with primary breast cancer: A randomised trial. European Journal of Cancer, 47, 1363–1372.

To test the effects of a group cognitive behavioral therapy (CBT) intervention on psychosocial symptoms in women with breast cancer

One to two weeks after surgery, women who agreed to participate were randomly assigned to a psychosocial intervention or a usual-care control group. The intervention consisted of 12 hours of education over a two-week period. Education provided information about treatment modalities, side effects, social rights, healthful diet, stress management, cognitive reframing, and sexuality issues. The intervention then involved meetings of eight women. Each group met weekly, in a 2.5-hour session, for eight weeks. In the sessions, the women shared experiences to reveal negative thinking and integrate the elements of cognitive therapy. Follow-up was up at 1, 6, and 12 months.

• The sample consisted of 176 women with breast cancer.
• In the intervention group, 61% were older than age 50; in the control group, 76% were older than age 50. Mean age and range were not stated.
• The majority of patients had received treatment with chemotherapy plus radiation therapy plus hormonal therapy.
• 74% of the women were married or cohabiting.

• Single site
• Outpatient setting
• Denmark

 Randomized controlled trial

• Profile of Mood States questionnaire
• Mental Adjustment to Cancer Scale
• EORT Quality of Life questionnaire
• Barrett-Lennard Relationship Inventory

At no time in the study did differences exist between groups in regard to mood disturbances, quality of life, or marital relationships.

The psychosocial intervention, consisting of cognitive behavioral techniques, had no effect on depression, anxiety, quality of life, or marital relationship.

• The study included baseline sample and group differences.
• The study presents risk of bias because it did not include blinding or an appropriate attentional control condition.
• Patients in the control group were older than patients in the intervention group. 
• The study does not make clear whether women were actively receiving adjuvant treatment during the study.

The CBT intervention tested had no observable effect on depression or anxiety in women with breast cancer.