Fobair, P., Koopman, C., DiMiceli, S., O'Hanlan, K., Butler, L. D., Classen, C., . . . Spiegel, D. (2002). Psychosocial intervention for lesbians with primary breast cancer. Psychooncology, 11, 427–438.

The intervention included twelve 90-minute meetings of a supportive-expressive group therapy led by a licensed clinical social worker; participants discussed problems, coping, treatment, mood, self-efficacy, relationships, pain, sleep, body image, and sexuality. Outcomes were emotional distress, mood, self-efficacy, body image, sexuality, social support, quality of life (QOL), pain, and sleep.

• The sample comprised 20 patients with stage I to IIIA breast cancer.
• Mean age was 47 years.
• Patients were post surgery.

Three community settings in Northern California

Patients were undergoing the active treatment phase of care.

The study used a one-group, pre-/posttest design.

Brief questionnaire based on the Structured Insomnia Interview to assess quality and quantity of sleep and daytime sleepiness

Patients undergoing 12 weeks of supportive group therapy showed statistically significant improvement in sleep (less waking during the night).

• The study had a small sample size and lacked a control group.
• Training is required to observe for unstable emotional status.
• A licensed clinical social worker familiar with supportive-expressive group therapy is needed.
• Cost is incurred for a space for the class and the instructor.