Meaning-Centered Grief Therapy for Parents Bereaved by Cancer

针对癌症失去亲人的父母进行以意义为中心的悲伤治疗

• 批准号: 8423441
• 负责人: Wendy G. Lichtenthal
• 金额: $ 14.13万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8423441
• 关键词: Address; Advanced Malignant Neoplasm; Age; Area; Award; Bereavement; Cancer Patient; Caregivers; Caring; Cause of Death; Child; Child Care; Clinical; Clinical Trials; Continuity of Patient Care; Data; Development; Disease; Distress; Environment; Ethnic Origin; Evaluation; Face; Family; Feedback; Funding; Gender; Goals; Grief reaction; Health; Improve Access; Individual; Institute of Medicine (U.S.); Intervention; Interview; Knowledge; Lead; Learning; Left; Life; Malignant Neoplasms; Manuals; Mediator of activation protein; Mental Health; Mental Health Services; Mentorship; Minority; Outcome; Outcome Study; Pain; Palliative Care; Parents; Persons; Phase; Pilot Projects; Process; Psychosocial Assessment and Care; Psychotherapy; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Risk; Role; Scientist; Services; Surveys; Symptoms; Syndrome; Therapeutic; Therapeutic Intervention; Time; Training; Treatment Efficacy; Underserved Population; United States National Institutes of Health; Videoconferences; Videoconferencing; Vulnerable Populations; active method; base; career development; cost; design; distress tolerance; end of life; experience; fighting; improved; informant; innovation; intervention effect; loved ones; novel; outreach; palliative; physical conditioning; post intervention; preference; programs; psychosocial; public health priorities; sound; statistics; theories; therapy design; trial comparing

DESCRIPTION (provided by applicant): Cancer is the leading cause of death by disease in children. Parents who lose a child to cancer are at heightened risk for numerous detrimental mental and physical health outcomes, including prolonged grief disorder (PGD), an impairing psychiatric syndrome that can persist for years if left untreated. Despite their increased risk, however, there is an absence of empirically-supported interventions for this highly vulnerable population. Furthermore, they appear to underutilize existing mental health services. There is a critical need to develop and empirically validate a theoretically-driven psychosocial intervention for parents bereaved by cancer that is acceptable and accessible (e.g., through telemental health). My long-term goal is to become an independent clinical scientist who focuses on the development of novel psychotherapeutic interventions for cancer patients and their families, specializing in grief interventions to improve continuity of care from palliative care through bereavement. This application represents the logical next step in my career development. My learning objectives during the award period are as follows: 1) to advance my training in psychotherapy research and theory, 2) to learn core principles and practical strategies needed to execute telemental health interventions, 3) to increase knowledge on recruitment/retention of minority and other underserved populations in clinical trials, 4) to advance my expertise in grief and attachment theory, and 5) to complete training in advanced statistics relevant to psychotherapy research. In addition to receiving intensive expert mentorship and didactic training in a well-suited environment, I will gain hands-on experience in these areas through the proposed research. The objective of this study is to refine and evaluate the feasibility and promise of Meaning-Centered Grief Therapy (MCGT), a novel one-on-one psychotherapeutic intervention designed to enhance bereaved parents' sense of meaning and reduce PGD symptoms. MCGT will be adapted from Meaning-Centered Psychotherapy, an empirically-supported intervention for advanced cancer patients. Bereaved parents' underutilization of and barriers to accessing mental health services will be addressed by delivering MCGT via videoconferencing, which has been shown to be as efficacious as in-person delivery. The study will consist of 4 phases, using key informants to adapt the MCGT intervention manual (Phase 1), a brief open trial to refine MCGT in person (Phase 2), a brief open trial to fine-tune delivery of MCGT via videoconferencing (Phase 3), and a pilot randomized controlled trial (RCT) to compare the feasibility, tolerability, acceptability, and preliminary effects of MCGT to a standardized supportive psychotherapy (SP), both delivered via videoconferencing (Phase 4). Conducting this study will contribute to my development into an independent grief intervention researcher for individuals bereaved by cancer while also providing feasibility and preliminary efficacy data that is critical to designing a larger-scale RCT of MCGT for bereaved parents. Findings from this study will be used to seek NIH R01 funding for a larger-scale efficacy RCT of MCGT, which, in addition to the proposed training, will advance my potential as an independent psychotherapy researcher in the cancer setting.

描述（由申请人提供）：癌症是儿童疾病死亡的主要原因。因癌症失去孩子的父母面临着许多有害的心理和身体健康后果的风险，包括长期悲伤障碍（PGD），这是一种损害性的精神综合征，如果不治疗，可能持续多年。然而，尽管他们的风险增加，但缺乏对这一高度脆弱群体的医疗支助干预措施。此外，他们似乎没有充分利用现有的心理健康服务。迫切需要开发和经验验证一种理论驱动的心理社会干预，用于癌症丧亲父母，这种干预是可接受的和可获得的（例如，通过远程健康）。我的长期目标是成为一名独立的临床科学家，专注于为癌症患者及其家属开发新型心理治疗干预措施，专门从事悲伤干预，以改善从姑息治疗到丧亲的护理连续性。这个应用程序代表了我职业发展的逻辑下一步。我在获奖期间的学习目标如下：1）推进我在心理治疗研究和理论方面的培训，2）学习执行远程健康干预所需的核心原则和实践策略，3）增加在临床试验中招募/保留少数民族和其他服务不足人群的知识，4）推进我在悲伤和依恋理论方面的专业知识，完成与心理治疗研究相关的高级统计学培训。除了在合适的环境中接受密集的专家指导和教学培训外，我还将通过拟议的研究获得这些领域的实践经验。本研究的目的是完善和评估意义为中心的悲伤疗法（MCGT）的可行性和承诺，一种新的一对一的心理治疗干预，旨在提高丧亲父母的意义感和减少PGD症状。MCGT将改编自意义中心心理疗法，这是一种针对晚期癌症患者的辅助性干预措施。将通过视频会议提供MCGT来解决丧亲父母对心理健康服务的利用不足和获得心理健康服务的障碍，视频会议已被证明与亲自提供一样有效。该研究将包括4个阶段，利用关键知情人调整MCGT干预手册（第1阶段），一个简短的开放试验，以改善MCGT的人（第2阶段），一个简短的开放试验，以微调交付 通过视频会议（3期）的MCGT，和一个试点随机对照试验（RCT），比较可行性，耐受性，可接受性，和标准化的支持性心理治疗（SP）的初步效果，都通过视频会议（4期）。进行这项研究将有助于我发展成为一名独立的悲伤干预研究人员，为癌症患者提供研究，同时提供可行性和初步疗效数据，这对于为丧亲父母设计更大规模的MCGT RCT至关重要。这项研究的结果将用于寻求NIH R 01资金，用于MCGT的大规模疗效RCT，除了拟议的培训外，还将提高我作为癌症背景下独立心理治疗研究人员的潜力。