Adapting Meaning-Centered Group Psychotherapy for Chinese Immigrant Patients with

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DESCRIPTION (provided by applicant): Spirituality and its role in end-of-life care has emerged as a central issue in palliative care. There have been several recent studies of terminally ill cancer patients, both by our research group and others, demonstrating the central role of spiritual well being, and sense of "meaning" in particular, in buffering against depression hopelessness, and desire for hastened death. We have developed, manualized, and pilot-tested just such a novel intervention - Meaning-Centered Psychotherapy (MCP). MCP, pilot-tested in an 8-week group format, is based on the principles of Viktor Frankl's work, and is designed to help patients with advanced cancer sustain or enhance a sense of meaning as they approach the end-of-life. Preliminary findings from our pilot randomized controlled trials demonstrate MCP significantly reduces psychological distress (e.g., depression, hopelessness, anxiety, and desire for hastened death), and significantly increase spiritual well-being and a sense of meaning and purpose in life in advanced cancer patients. The overall aim of the current proposal is to adapt the Meaning-Centered Group Psychotherapy (MCGP) intervention for Chinese immigrant cancer patients (MCGP-Ch), a large, underserved and understudied ethnic minority group. We will adapt the MCGP intervention to be culturally and linguistically targeted for this population, the resulting intervention will be used to apply for a subsequent grant to pilot test MCGP-Ch for feasibility, acceptability, and satisfaction. Culturally adapted treatments have been demonstrated to be more effective than those that have not been adapted, treatments with greater numbers of cultural adaptations tend to be most effective, and interventions targeted for a specific ethnic group are more effective than those delivered to patients from a variety of backgrounds. To inform the adaptation of the intervention, we will conduct a community needs assessment as well as 15-20 in-depth interviews with Chinese immigrants with advanced cancer, using the Ecological Validity Model (EVM) of Bernal et al. and the Cultural Adaptation Process (CAP) model of Domenech-Rodriquez and Weiling.