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

基本信息

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
项目类别：
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

项目摘要

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许多有害的精神和身体健康结果的风险更高，包括长期悲伤障碍（PGD），这是一种损害性的精神综合症，如果不及时治疗，可能会持续数年。然而，尽管风险增加，但针对这一高度脆弱人群缺乏经验支持的干预措施。此外，他们似乎没有充分利用现有的心理健康服务。迫切需要为罹患癌症的父母制定一种可接受且可获得的理论驱动的心理社会干预措施（例如通过远程心理健康），并通过实证进行验证。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人开发新型心理治疗干预措施，专门从事悲伤干预措施，以改善从姑息治疗到丧亲之痛的护理连续性。该应用程序代表了我职业发展中合乎逻辑的下一步。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）学习执行远程心理健康干预所需的核心原则和实践策略，3）增加有关招募/保留少数群体的知识和临床试验中其他服务不足的人群，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以意义为中心的悲伤疗法 (MCGT) 的可行性和前景，这是一种新型的一对一心理治疗干预措施，旨在增强失去亲人的父母的意义感并减少 PGD 症状。 MCGT 将改编自意义中心心理治疗，这是一种针对晚期癌症患者的经验支持的干预措施。通过视频会议提供 MCGT 可以解决失去亲人的父母未充分利用心理健康服务以及获得心理健康服务的障碍，事实证明，视频会议与面对面提供一样有效。该研究将分为 4 个阶段，利用关键信息提供者来调整 MCGT 干预手册（第 1 阶段）、亲自完善 MCGT 的简短公开试验（第 2 阶段）、微调交付的简短公开试验通过视频会议进行 MCGT（第 3 阶段），以及一项试点随机对照试验 (RCT)，以比较 MCGT 与标准化支持性心理治疗 (SP) 的可行性、耐受性、可接受性和初步效果，两者均通过视频会议进行（第 4 阶段）。进行这项研究将有助于我发展成为一名针对癌症失去亲人的独立悲伤干预研究者，同时还提供可行性和初步疗效数据，这对于为失去亲人的父母设计更大规模的 MCGT 随机对照试验至关重要。这项研究的结果将用于寻求 NIH R01 资助，以进行更大规模的 MCGT 疗效随机对照试验，除了拟议的培训之外，还将提高我作为癌症环境中独立心理治疗研究员的潜力。