Cancer-related communication during sessions of family therapy at the end of life Journal Article


Authors: Zaider, T. I.; Kissane, D. W.; Schofield, E.; Li, Y.; Masterson, M.
Article Title: Cancer-related communication during sessions of family therapy at the end of life
Abstract: Objectives: A goal of family-focused therapies in oncology is to help families communicate effectively about illness and its management. Yet there has been no examination of whether and how conjoint sessions are conducive to this process. In this study, we (a) described the extent of cancer-specific communication during family sessions at the end of life; (b) identified characteristics associated with SC; and (c) determined the association between SC and longer-term family bereavement outcomes. Methods: Data were collected as part of a randomized controlled trial of Family Focused Grief Therapy (FFGT) for advanced cancer patients and their families. Demographics, depressive symptoms, and family functioning were assessed at baseline. Cancer-specific communication, perceived responsiveness to communication, and therapeutic alliances were reported after each session. At 13-month bereavement, surviving families were assessed for symptoms of depression and prolonged grief disorder (PGD). Results: Participants were 257 advanced cancer patients and family members receiving FFGT at the end of life. On average, participants perceived significantly more cancer-related communication in session (SC) than at baseline. Both therapist-family and within-family alliances were associated with SC, especially for those with more severe depressive symptoms at baseline. Long-term outcomes were moderated by perceived responsiveness to in-session communication: for those who perceived high responsiveness, SC was associated with fewer depressive and PGD symptoms in bereavement. Conclusions: Conjoint family sessions can effectively increase communication about cancer at the end of life. Clinicians should consider key contextual factors in their effort to facilitate this process: perceived responsiveness, family role, alliances with therapist, and within-family. © 2019 John Wiley & Sons, Ltd.
Keywords: adult; controlled study; middle aged; major clinical study; advanced cancer; palliative care; randomized controlled trial; depression; disease severity; communication; long term care; bereavement; interpersonal communication; terminal care; family therapy; caregivers; family functioning; long-term outcomes; complicated grief; therapeutic alliance; human; male; female; article; alliance; malignant neoplasm; therapy process
Journal Title: Psycho-Oncology
Volume: 29
Issue: 2
ISSN: 1057-9249
Publisher: John Wiley & Sons  
Date Published: 2020-02-01
Start Page: 373
End Page: 380
Language: English
DOI: 10.1002/pon.5268
PUBMED: 31701610
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 2 March 2020 -- Source: Scopus
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MSK Authors
  1. Yuelin Li
    219 Li
  2. Talia I Zaider
    57 Zaider
  3. Elizabeth A Schofield
    161 Schofield