Manne, S.L., Rubin, S., Edelson, M., Rosenblum, N., Bergman,  Hernandez, E., . . . Winkel, G. (2007). Coping and communication-enhancing intervention versus supportive counseling for women diagnosed with gynecological cancers. Journal of Consulting and Clinical Psychology, 75(4), 615–628.

Study Purpose

To compare the efficacy of two psychological interventions to the efficacy of usual care

Intervention Characteristics/Basic Study Process

The coping- and communication-enhancing intervention (CCI) involved challenging assumptions and talking about thoughts and feelings with others. Six hour-long individual sessions were supplemented with a final by-telephone booster session. Session content focused on enhancing coping, educating, and practicing skills; home practice assignments were included. Supportive counseling (SC) involved six hour-long sessions and a by-telephone booster. Rather than topic discussion, SC stressed reactions to cancer, support of existing coping behaviors, and autonomy. Usual care included routine social work consultations. Nineteen experienced therapists provided intervention. Participants were randomly assigned to CCI, SC, or usual care and were assessed preintervention and at three, six, and nine months.

Sample Characteristics

The study included 353 women with primary gynecologic cancer who were in active treatment.

Setting

  • Two comprehensive cancer centers and eight hospitals
  • Three states in the United States

Measurement Instruments/Methods

  • Beck Depression Inventory
  • Impact of Event Scale
  • Emotional Expressiveness Questionnaire
  • Cancer Rehabilitation Evaluation System subscale
  • Modified Expectancy Rating Form
  • A version of Borkovec and Nau’s evaluation of treatment credibility

Conclusions

For all patients, symptoms of depression decreased at first. For patients in CCI and SC, symptoms of depression remained relatively flat after six months, but in usual care they began to increase. Authors reported no significant difference between the interventions’ effects and no impact of either intervention on cancer-specific distress.

Limitations

  • The RCT was poorly designed, with a high rate of refusal and lack of survey completion.
  • The sample was primarily Caucasian, young, and had ovarian cancer; this lack of diversity limits generalizability.
  • Participants were paid $25 for each survey or session, a relatively high compensation.
  • Different therapists were used for SC and CCI.