Psychotherapy for Advanced Cancer in Latinos

Recruiting at 3 trial locations

Overseen By William Breitbart, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Memorial Sloan Kettering Cancer Center

Disqualifiers: Cognitive impairment, Major disabling condition, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

190 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to adapt a counseling intervention called Meaning Centered Psychotherapy to make it culturally relevant for Latinos. Cancer affects patients and their loved ones. Latinos often experience greater challenges due to the cancer. However, few studies and interventions focus on Latinos. We are interested in understanding what affects Latino patients' quality of life, and how to improve it

Do I need to stop my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications. It seems likely that you can continue them, especially if your psychiatric disorder is well controlled by treatment.

What data supports the idea that Psychotherapy for Advanced Cancer in Latinos is an effective treatment?

The available research shows that Meaning-Centered Psychotherapy (MCP) is effective in improving the quality of life, hope, optimism, and well-being in people with cancer. Although most studies have been conducted with non-Hispanic white patients, a survey of Latino advanced cancer patients and caregivers found that a large majority rated the concepts of MCP as extremely important. Specifically, 86.8% of participants valued finding meaning in life after a cancer diagnosis, and 80.7% emphasized the importance of finding and maintaining hope. This suggests that MCP is well-received and potentially effective for Latino patients with advanced cancer. ^{1 2 3 4 5}

What safety data exists for Meaning-Centered Psychotherapy in Latinos with advanced cancer?

The available studies primarily focus on the efficacy and cultural adaptation of Meaning-Centered Psychotherapy (MCP) for Latino patients with advanced cancer, rather than specific safety data. These studies highlight the need for cultural adaptation to improve comprehension and acceptance among Latino patients, particularly in Puerto Rican populations. While safety is not explicitly addressed, the studies emphasize the importance of integrating family and addressing cultural factors to enhance the therapy's effectiveness and acceptance. ^{2 4 6 7 8}

Is Meaning Centered Psychotherapy a promising treatment for Latino patients with advanced cancer?

Yes, Meaning Centered Psychotherapy is a promising treatment for Latino patients with advanced cancer. It helps improve their spiritual and emotional well-being, and many patients and caregivers find it important and helpful in coping with cancer. The therapy has been adapted to fit Latino cultural values, making it more effective and acceptable for this group. ^{1 2 3 9 10}

Research Team

Rosario Costas-Muniz, PhD

Principal Investigator

Memorial Sloan Kettering Cancer Center

Eligibility Criteria

This trial is for Latino adults diagnosed with advanced stage III or IV solid tumor cancer who can communicate and read in Spanish. Participants must agree to audio recordings and not have significant cognitive impairments, major disabling conditions, or be too ill to consent.

Inclusion Criteria

Have a caseload of five or more Latino cancer patients per month

I am willing and able to be interviewed only in Spanish.

Phase 3: Provider Feedback

Exclusion Criteria

Unable to understand the consent procedure

I do not have significant memory or thinking problems that would prevent me from understanding this study.

In the judgment of the consenting professional, significant or major disabling medical or psychiatric condition sufficient to preclude meaningful informed consent, interview, or completion of assessment measures (patients whose psychiatric disorder is well controlled by treatment will be eligible)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Phase 1 and 2: Understanding and Feasibility

The study team gains an understanding of sources of meaning, hope, legacy, and identity in Latino patients with advanced cancer and explores the acceptability and feasibility of applying IMCP.

Not specified

Phase 3: Key Informant Feedback

Mental health providers are interviewed to explore additional needed adaptations.

Not specified

Phase 4: Pre-piloting

Patients are interviewed to assess the comprehension and acceptability of the adapted intervention.

Not specified

Follow-up

Participants are monitored for changes in depression, anxiety, and spiritual well-being using validated scales.

7-14 weeks

Treatment Details

Interventions

• Meaning Centered Psychotherapy for Latinos
• Meaning Centered Psychotherapy for Latinos for Waitlist Control Patients

Trial Overview The study aims to adapt Meaning Centered Psychotherapy for Latinos with advanced cancer. It assesses how this culturally tailored counseling intervention affects their quality of life through pre-assessment questionnaires and spiritual well-being scales.

Participant Groups

Group I: Meaning Centered Psychotherapy for Latinos (MCP-L) Experimental Treatment 4 Interventions

Group II: Control Active Control 4 Interventions

Meaning Centered Psychotherapy for Latinos is already approved in United States for the following indications:

Approved in United States as Meaning-Centered Psychotherapy for:

• Advanced cancer
• Improving quality of life
• Spiritual well-being

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials

1,998

Recruited

602,000+

Lincoln Medical and Mental Health Center

Collaborator

Trials

11

Recruited

2,100+

Findings from Research

A study involving 22 Spanish-speaking advanced cancer patients revealed six new themes related to their experiences in meaning-centered group psychotherapy (MCGP), highlighting the importance of addressing specific cultural and emotional needs.

The most common issues identified were 'threat' and 'uncertainty,' suggesting that these factors significantly impact the well-being of Spanish-speaking patients and should be integrated into future adaptations of MCGP for Latin American populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychological aspects of meaning-centered group psychotherapy: Spanish experience. Fraguell, C., Limonero, JT., Gil, F.[2019]

A case study of a Puerto Rican patient with advanced cancer revealed that while the patient had low comprehension of some key concepts in meaning-centered psychotherapy (MCP), they showed high understanding of death and dying, indicating a need for culturally tailored interventions.

The patient demonstrated high acceptance of involving family in therapy, suggesting that MCP could be adapted to better fit the collectivist values of Latinx cultures, making it a potentially effective psychotherapy for improving spiritual well-being and quality of life in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comprehension and acceptance of the Meaning-Centered Psychotherapy with a Puerto Rican patient diagnosed with advanced cancer: A case study. Torres-Blasco, N., Castro, E., Crespo-Martín, I., et al.[2021]

A survey of 57 Latino advanced cancer patients and 57 caregivers revealed that a high percentage (73.75% to 95.5%) found Meaning-Centered Psychotherapy (MCP) concepts extremely important for coping with their diagnosis.

The majority of participants (80.7%) emphasized the significance of finding and maintaining hope, and 86.8% valued finding meaning in life after a cancer diagnosis, indicating strong support for culturally tailored psychosocial interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Importance of Communication Skills Training and Meaning Centered Psychotherapy Concepts among Patients and Caregivers Coping with Advanced Cancer. Torres-Blasco, N., Rosario-Ramos, L., Navedo, ME., et al.[2023]

This study aims to evaluate the efficacy of Meaning-Centered Psychotherapy (MCP) for Spanish-speaking cancer patients in a randomized control trial, comparing it to Cognitive Behavioral Therapy (CBT), with assessments at pretreatment, post-treatment, and 6-month follow-up.

The research will also explore the feasibility and acceptance of MCP in this population, potentially confirming its effectiveness in improving quality of life and reducing anxiety and depression among cancer patients who have completed their main medical treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial. Marco, JH., Llombart, P., Guillén, V., et al.[2022]

Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C) is designed to address existential distress, a significant but often overlooked aspect of caregiver burden in those caring for patients with advanced cancer.

A case study from an initial MCP-C group revealed that participants experienced personal growth, improved self-care, and a deeper understanding of their caregiving experience, highlighting the potential benefits of this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C): Rationale and Overview. Applebaum, AJ., Kulikowski, JR., Breitbart, W.[2022]

Patients with advanced cancer in Puerto Rico demonstrated low comprehension and acceptance of Meaning-Centered Psychotherapy (MCP) concepts, particularly regarding meaning, death, and legacy.

Participants expressed a strong desire to include family members in their therapy, indicating that interventions should be tailored to improve understanding and address end-of-life concepts more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cultural Adaptation and Open Pilot of Meaning-Centered Psychotherapy for Puerto Rican Patients with Advanced Cancer. Torres-Blasco, N., Castro-Figuero, E., Garduño-Ortega, O., et al.[2021]

The study identified key facilitators and barriers to implementing Meaning-Centered Psychotherapy (MCP) for Latino cancer patients, emphasizing the need for cultural adaptation and flexibility in the intervention's delivery.

Factors such as the clinic environment, patient education, and provider training were crucial for successful implementation, highlighting the importance of addressing these pre-implementation needs to enhance the usability and acceptability of MCP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

International adaptation of Meaning-Centered Psychotherapy for Latinos: Providers' views on pre-implementation. Costas-Muñiz, R., Torres-Blasco, N., Castro-Figueroa, EM., et al.[2023]

The pilot study involving 30 patients with advanced cancer showed that Meaning-Centered Psychotherapy and Essential Care (MCP-EC) significantly reduced symptoms of anxiety, depression, and hopelessness, while enhancing spiritual well-being and a sense of meaning.

Patients reported high satisfaction with the MCP-EC intervention, indicating its feasibility and acceptability compared to usual psychological support, although further research with larger samples is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An adaptation of meaning-centered psychotherapy integrating "essential care": A pilot study. Quílez-Bielsa, E., Barrado-Moreno, V., Lastra Del Prado, R., et al.[2022]

Mental health providers face significant challenges when counseling Latino cancer patients, particularly regarding discussions about diagnosis, prognosis, and end-of-life issues, highlighting the need for culturally sensitive approaches.

The study involved 66 mental health professionals who provided insights into these challenges, emphasizing the importance of understanding provider experiences to improve training and interventions for better patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Maintaining hope:" challenges in counseling latino patients with advanced cancer. Costas-Muñiz, R., Garduño-Ortega, O., Torres-Blasco, N., et al.[2023]

A study involving 70 mental health professionals and 54 Latino patients with advanced cancer showed that culturally and linguistically adapted meaning-centered psychotherapy is highly acceptable and relevant for this population.

Qualitative interviews with 24 Latino patients highlighted the importance of simplifying language, using culturally relevant metaphors, and ensuring that the intervention aligns with Latino cultural values to improve psychological adjustment and well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meaning-Centered Psychotherapy for Latino Patients with Advanced Cancer: Cultural Adaptation Process. Costas-Muñiz, R., Torres-Blasco, N., Castro-Figueroa, EM., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Psychological aspects of meaning-centered group psychotherapy: Spanish experience. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Comprehension and acceptance of the Meaning-Centered Psychotherapy with a Puerto Rican patient diagnosed with advanced cancer: A case study. [2021]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Importance of Communication Skills Training and Meaning Centered Psychotherapy Concepts among Patients and Caregivers Coping with Advanced Cancer. [2023]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Spanish Adaptation of Meaning-Centered Psychotherapy for Participants With Cancer: Study Protocol of a Randomized Control Trial. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C): Rationale and Overview. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Cultural Adaptation and Open Pilot of Meaning-Centered Psychotherapy for Puerto Rican Patients with Advanced Cancer. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

International adaptation of Meaning-Centered Psychotherapy for Latinos: Providers' views on pre-implementation. [2023]

8. England pubmed.ncbi.nlm.nih.gov

An adaptation of meaning-centered psychotherapy integrating "essential care": A pilot study. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

"Maintaining hope:" challenges in counseling latino patients with advanced cancer. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Meaning-Centered Psychotherapy for Latino Patients with Advanced Cancer: Cultural Adaptation Process. [2021]