Meaning-Centered Grief Therapy for Parents Bereaved by Cancer

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许多有害的精神和身体健康后果的风险更高，包括长期悲伤障碍（PGD），这是一种损害精神的综合征，如果不及时治疗，可能会持续数年。然而，尽管他们的风险增加，但缺乏经验支持的针对这一高度脆弱人群的干预措施。此外，他们似乎没有充分利用现有的精神卫生服务。迫切需要为因癌症而失去亲人的父母制定并在经验上验证一种理论驱动的心理社会干预措施，这种干预措施是可接受和可获得的（例如，通过远程心理健康）。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的心理治疗干预措施，专门从事悲伤干预，以提高从姑息治疗到丧亲的护理连续性。这份申请代表了我职业发展的下一步。我在获奖期间的学习目标如下：1)加强我在心理治疗研究和理论方面的培训，2)学习实施远程心理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)提高我在悲伤和依恋理论方面的专业知识，5)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中心悲伤疗法（MCGT）的可行性和前景，这是一种新型的一对一心理治疗干预，旨在增强丧亲父母的意义感和减轻PGD症状。MCGT将改编自以意义为中心的心理治疗，这是一种针对晚期癌症患者的经验支持干预。将通过视频会议提供MCGT来解决丧亲父母对精神卫生服务利用不足和获得精神卫生服务的障碍问题，视频会议已被证明与面对面提供服务一样有效。该研究将包括4个阶段，使用关键线人来调整MCGT干预手册（第一阶段），一个简短的公开试验来完善MCGT（第二阶段），一个简短的公开试验来微调交付

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.