Therapy Processes, Progress, and Outcomes for Two Therapies for Gynecological Cancer Patients

Abstract

Objective

Although a number of effective psychotherapies have been identified for cancer patients, little is known about therapy processes as they unfold the course of treatment and the role of therapy processes in treatment outcome. We used growth curve modeling to evaluate the associations between therapy processes and outcomes among gynecological cancer patients participating in two types of therapy.

Methods

Two hundred twenty five women newly diagnosed with gynecological cancer were randomly assigned to receive eight sessions of a coping and communication intervention (CCI) or a client-centered supportive therapy (SC). Participants completed measures of pre-intervention and post-intervention depression, working alliance after Session 2, and post-session progress and depressive symptoms after each session. Therapists completed measures of perceived patient progress.

Results

Both patients and therapists reported a steady increase in session progress and patients reported a steady decrease in depressive symptoms over the course of both the CCI and SC sessions. Perceived progress in one session predicted progress in the subsequent session. Early working alliance predicted improved session progress and reductions in post-session depressive symptoms over sessions. Working alliance did not predict pre-post treatment changes in depression. Patient-rated session progress predicted greater reductions in pre-to post-treatment depression, but therapist-rated progress did not.

Conclusions

For two types of treatment delivered to women diagnosed with gynecological cancer, patient-rated session progress and depressive symptoms rated over therapy sessions may serve as a yardstick that can be useful to therapists to gauge patient's response to treatment.

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