Effectiveness of SEGT

Our effectiveness study ‘Supportive-expressive group therapy for women with metastatic breast cancer: Improving Access for Australian women through use of teleconference’  published in Counselling and Psychotherapy Research in 2008 is cited in Bergen and Garfield’s Handbook of Psychotherapy and Behaviour Change, 6th Ed. (2013).

It is one of 23 international studies cited investigating the efficacy and effectiveness of groups for women with breast cancer over the last decade 2000-2011. It is one of 9 studies of SEGT and the only non RCT included from that time. 8 out of the 9 studies focused on metastatic breast cancer with only one on primary breast cancer.

The authors of the chapter Gary Burlingame, Bernhard Strauss and Anthony S. Joyce say they selected the “best efficacy and effectiveness studies” they could find for inclusion in the chapter.

They report some interesting findings across all group interventions with women with breast cancer.

For SEGT, they found

  • good evidence for improved psychological distress on the POMS, IES (including in ours)
  • mixed findings on QOL using the EORTC QL-30 (we have not published on this):
    Kissane, 2007 showed improvement; whereas Bordelau, 2003 did not 2 studies (Giese-Davis, 2002, Kissane, 2007 found SEGT increased adjustment to cancer; whereas Classen, 2008 (the only study on women with primary bc) showed no effect 3 other RCTs found effect on adjustment to cancer with women with metastatic breast cancer
  • no evidence of survival benefit
  • coping with illness on IES/POMS enhanced in 4 studies, including ours but no effect for women with primary breast cancer (Classen, 2008)
  • 2 studies found less worsening of pain over time but overall SEGT has small impact on pain

For Psycho-educational groups PEG – 5 studies – they found

  • smaller effects for educational interventions compared to therapeutic interventions.
  • primary effects are in reducing distress – uniform results on this.

Peer support groups led by poorly trained leaders produce suboptimal effects.

For Psycho educational groups for partners of breast cancer patients, they found

  • reduced distress, depression and improved wellbeing and marital satisfaction. (Bultz, 2003; Manne, 2005)

Overall the most reliable effect for SEGT, CBT and PEG was reduced emotional distress. The authors wondered if when not achieved, how much this related to initial distress.

SEGT and CBT are both reliable in improving coping with illness, but not so for PEG.

SEGT may have the edge on improving life adjustment but is more costly.

One new study by Antoni, 2006 founds groups produced more improvement on psychological distress and coping than information dissemination alone.

In summary, SEGT is an empirically supported therapy EST and we can be confident that we are delivering evidence based practice EBP through the Advanced Breast Cancer Group.

The rest of the chapter had information on clinical guidelines (Bernard, Burlingame, Flores, Greene, Joyce, Kobos, Feirnan 2008) which could be useful in the development of training in SEGT for women with metastatic breast cancer.

These findings support our goal to have more people trained in delivering SEGT to reach more women living with secondary breast cancer in Queensland and Australia.