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Mindfulness-based cognitive therapy (MBCT) is an innovative evidence-based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet-based versus group-based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group-based MBCT out of 120 patients who were randomized to group-based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT., (© 2019 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

ABSTRACTObjective:Our aim was to identify the themes that arise when applying adapted meaning-centered group psychotherapy (MCGP) in Spanish-speaking advanced cancer patients., Method: A mixed qualitative-quantitative analysis was performed on the transcripts of interviews with 22 advanced cancer patients who had been assigned to three MCGP subgroups., Results: We found six new emergent themes in addition to the originally constructed themes of MCGP. Threat and uncertainty were the two most frequent emergent issues for our Spanish patients., Significance of Results: The implementation of MCGP in Spanish patients validated the themes proposed by Breitbart and colleagues' foundational work on MCGP and also suggested new issues relevant to patient well-being (classified as "emergent themes"). Taking our findings into account, we propose that these new themes be considered in the Spanish adaptation of MCGP as well as in future adaptations of this form of psychotherapy in treating Latin American patients.

Objective: Young adults with cancer experience high levels of psychological distress. Group interventions for cancer patients have been effective in reducing levels of psychological distress but suffer from high levels of attrition and serve a limited geographic area. In a quality-improvement project, we converted an existing in-person support group to a telemedicine format in the hopes of improving attendance and reducing geographic disparities in access to care., Method: Eight young adults (18-40 years) with cancer were recruited from across Colorado. Participants received a tablet equipped with Wi-Fi and downloaded an HIPAA-compliant video-conferencing application. Participants attended six weekly supportive psychotherapy sessions., Results: Participants found the group to be beneficial: the technology worked, they enjoyed the group format, and they would recommend it to others. The novel treatment interface allowed for low attrition rates due to the flexibility of a patient's location during the intervention. It allowed for provision of services to a geographically diverse population of medically ill young adults, as participants lived an average of 148 miles from the cancer center (range = 25-406 miles)., Significance of Results: Internet-based mental health care is an area of growing interest for providers, but few studies have evaluated its efficacy in patients with cancer, and even fewer in young adults with cancer. Incorporating technological advances into clinical practice will increase access to care, reduce geographic health disparities, and provide more consistent services.

Purpose: The aim of this study was to evaluate the feasibility and acceptability of "Cascade": an online, group-based, cognitive behavioral therapy intervention, delivered "live" by a psychologist, to assist parents of children who have completed cancer treatment., Methods: Forty-seven parents were randomized to Cascade (n = 25) or a 6-month waitlist (n = 22). Parents completed questionnaires at baseline, 1-2 weeks and 6 months post-intervention. Thirty parents completed full evaluations of the Cascade program (n = 21 randomized to Cascade, n = 9 completed Cascade post-waitlist)., Results: Ninety-six percent of Cascade participants completed the intervention (n = 24/25). Eighty percent of parents completed every questionnaire (mean completion time 25 min (SD = 12)). Cascade was described as at least "somewhat" helpful by all parents. None rated Cascade as "very/quite" burdensome. Parents reported that the "online format was easy to use" (n = 28, 93.3 %), "I learnt new skills" (n = 28, 93.3 %), and "I enjoyed talking to others" (n = 29, 96.7 %). Peer-to-peer benefits were highlighted by good group cohesion scores., Conclusions: Cascade is highly acceptable and feasible. Its online delivery mechanism may address inequities in post-treatment support for parents, a particularly acute concern for rural/remote families. Future research needs to establish the efficacy of the intervention., Trial Registration: ACTRN12613000270718, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12613000270718.

The stress and psychological difficulties of siblings of children with cancer is well documented. Siblings must cope with a myriad of emotions, isolation from the family, and many changes in daily life. Therefore, a need exists to determine the effects of psychosocial interventions on siblings of cancer patients. The support group is one psychosocial intervention that has been suggested as a method to relieve stress and enhance coping. A quasi-experimental design was selected to determine the effects of participation in a support group on the social adjustment of siblings of children with cancer. Conclusions suggest that a support group provides siblings with the opportunity to decrease their sense of isolation, ventilate negative feelings, and learn from each other. Additionally, descriptive data suggest a need for ongoing follow-up with siblings to help them manage the stresses emerging from the impact of the diagnosis and treatment on the family. Implications of this study suggest that nurses should organize support groups for siblings and/or refer them to existing groups. Also, this study suggests the need to work with siblings and educate parents regarding sibling concerns.