Living in the shadow: a personal construct model of adjustment to breast cancer survival and tests of its clinical usefulness

This research demonstrated the contribution that personal construct theory makes to understanding women\u27s experiences of breast cancer, and based on this understanding, showed how to effectively support these women as they adjust to the ongoing task of living as breast cancer survivors. To achieve this aim a personal construct model of women\u27s adjustment to breast cancer survival was developed. Study 1, a qualitative study, was conducted with focus groups and individual interviews to elicit from the participants (n =59) their major concerns. The findings showed that breast cancer survivors live with threat to their core understandings about themselves, their relationships, and their ways of being in the world. Study 2 (the Retreat study) examined the role of validation of current meanings, and Study 3 (the group therapy study) evaluated validation and elaboration of new meanings on women\u27s levels of emotions. Study 2, with 40 breast cancer survivors, showed that validation of current meanings alone is not enough to effect lasting improvement in women\u27s levels of threat to their physical and psychological integrity, threat to existence, dislocation, or in levels of hope. Study 3 evaluated personal construct group therapy with 42 breast cancer survivors. The findings showed that the group therapy, providing opportunities for women to have their current meanings confirmed, and to elaborate new and more helpful meanings, resulted in significant initial decreases in threat, threat to existence and dislocation, and gains in levels of hope, which were maintained at the three month follow-up. The limitation of this series of studies, suggestions for future research on the mediational processes of adjustment to breast cancer survival, the usefulness of the personal construct model, and the clinical implications of the research, are discussed

Investigating the Role of Physical Symptoms on Important Goal Pursuit in Early-Stage Breast Cancer Patients

Abstract presented at the IPOS 15th World Congress of Psycho-Oncology, 4-8 November 2013, Rotterdam, Netherland

When the unreal becomes real: An evaluation of personal construct group psychotherapy with survivors of breast cancer

This chapter reports on the benefits, in terms of decreased levels of negative affect and an increase in positive affect, of a personal construct group therapy developed to work therapeutically with women diagnosed with nonmetastatic breast cancer. What follows is a brief description of the therapy, and then the participants are introduced. Accounts of the research design and measures used precede the presentation of the statistical results. This is followed by an account of the participants\u27 evaluation of their experience of the therapy. Together, the findings suggest that personal construct concepts and practices have much to contribute to current understanding of how we, as therapists, may help women adjust to breast cancer survival

Role relationships and the restoration of coherence in the stories of women diagnosed with breast cancer

Within personal construct theory, relationships with others, based on a mutual intention to understand each other\u27s construction processes, are considered to be a primary source of validation and invalidation of meaning-making. A major task of psychotherapeutic work with people facing the ongoing threat of breast cancer, therefore, is to facilitate interpersonal opportunities in which individuals can formulate, test and elaborate their ongoing stories about themselves. Personal construct ideas relating to meaning-making; including the experience cycle, role relationships and support are presented in this chapter. These concepts provide the framework for personal construct group work aimed at restoring a sense of coherence in women living with breast cancer\u27s ongoing stories of surviva

The link between value motives, value success, and well-being among people diagnosed with cancer

Objective: This study investigated the relationship between cancer patientÿs values and cancerrelated distress.Method: A total of 107 patients with cancer diagnoses completed an anonymousquestionnaire.Results: Less self-regulating motivation for health values was significantly related to poorerwell-being. Greater success at living oneÿs values was significantly related to improved wellbeingand distress-related outcomes. Sex difference analysis suggested that success atfriendship values was linked to less cancer-related distress among women, but not men, whereassuccess at romantic relationship values was linked to less distress among men, but not women.Conclusion: The results have important implications for values focused interventions,highlighting the importance of facilitating success at valued living and attending to sexdifferences among cancer patients

Investigating the role of physical symptoms on important goal pursuit in early-stage breast cancer patients

BACKGROUND: The diagnosis and treatment of early-stage breast cancer can interrupt ongoing goal-directed behaviour, and disrupt or completely block the pursuit of important personal goals. Symptoms of pain, fatigue, and insomnia are common across different treatments. Patients who report this particular cluster of symptoms are highly susceptible to functional impairment and poor psychological outcomes. This prospective study sought to better understand the relationship between physical symptoms and personal goal pursuit in breast cancer patients over time. METHOD: Forty-three women recently diagnosed with early-stage breast cancer provided self-report data at 1, 2, 4 and 6 months post-surgery. Questionnaires assessed physical symptoms, cancerrelated goal interference, and psychological distress. Non-parametric correlations, cluster analysis and one-way analysis of variance were conducted to test the study hypotheses. RESULTS: The 5 most prevalent symptoms at each time-point were pain, difficulty sleeping, lack of energy, feeling drowsy and difficulty concentrating. Goal interference was significantly correlated with pain at T1, difficulty sleeping and feeling drowsy at T2, lack of energy at T2-T4, and difficulty concentrating at T1- T4. Women in the moderate-to-high symptom cluster had significantly higher average goal interference, depression, anxiety and stress than women in the low-to-moderate cluster at each time-point. CONCLUSIONS: These novel findings indicate that common treatment-related physical symptoms differentially impact on the personal goal pursuit of breast cancer patients in the months following surgery. As expected, cancer-related goal interference was higher in women experiencing higher combined levels of these symptoms. Women in this subgroup also reported higher levels of psychological distress. RESEARCH IMPLICATIONS: This study provides important insight into the impact of cancer diagnosis and treatment on important goal pursuit, an under-researched topic in oncology. More research is needed to further explore the role of physical symptoms on goal pursuit in the shortand long-term following a cancer diagnosis. CLINICAL IMPLICATIONS: The findings suggest that women who experience high levels of pain, insomnia and fatigue at one or multiple times following surgery may require ongoing psychosocial support to help them cope with goal interference, disengage from unattainable goals and continue pursuing goals that remain attainable