Targ, E.F., & Levine, E.G. (2002). The efficacy of a mind–body–spirit group for women with breast cancer: A randomized controlled trial. General Hospital Psychiatry, 24, 238–248.

The study compared a complementary and alternative medicine (CAM) group intervention to a standard psychosocial support group.

The 12-week standard psychosocial support group meeting was offered weekly. A trained clinical psychologist taught cognitive behavioral therapy using group sharing and supportive therapies. Topics included coping with real-life issues, communication, body image, sexuality, grief, anger, anxiety management, and problem solving.

The 12-week CAM group meeting was offered twice a week. This group was taught meditation, affirmation, imagery, and ritual. Each session was two and one-half hours. The Tuesday session was a one-hour, RN-run, health-series discussion group, with topics including nutrition, exercise, menopause, lymphedema, pain management, sexuality, and others as requested by the group. The next 90 minutes were spent in six yoga classes and six dance therapy sessions. The Thursday session was one hour of experiential work using silent meditation, guided imagery, and writing and drawing exercises. The final 90 minutes was devoted to a discussion group led by a licensed clinical social worker exploring themes of experiential work as well as general support by the group. Topics included relationship with cancer, views of healing, sexuality, body image, death and dying, compassion, anger, forgiveness, and healing.

• The sample was comprised of 181 women with breast cancer within 18 months of initial diagnosis or who had been diagnosed with metastatic breast cancer.
• The CAM group had 93 participants; the standard support group had 88 participants.
• Twenty-seven were randomized to groups but never showed up for either group (6 in CAM group, 21 in standard support group).

A randomized controlled trial design was used.

• Functional Assessment of Chronic Illness Therapy (FACIT): Quality of life
• FACIT-Sp: Spiritual Well-being Scale
• Profile of Mood States (POMS)
• Principles of Living Survey: Spiritual well-being

• The CAM group showed significant decrease in distress as measured by POMS.
• Both groups showed significant decreases on the POMS anxiety subscales.
• Both groups were essentially equal in producing significant amount of change in anxiety over time.

• In this community, women choosing to participate in the study did so because they were willing or hoping to get into the CAM program: 7 dropped out from the CAM group compared to 17 dropouts from the standard support group.
• Specialized training was required to facilitate groups teaching cognitive behavioral education.
• Both groups had high effect size, without sufficient power to detect possible differences between groups on POMS measure.
• Which CAM intervention of the many offered helped with anxiety was unable to be ascertained.