Table Of ContentMeaning-Centered
Group Psychotherapy for
Patients with Advanced
Cancer
Meaning-Centered
Group Psychotherapy
for Patients with
Advanced Cancer
A Treatment Manual
WILLIAM S. BREITBART, MD
Interim Chairman
Chief, Psychiatry Service, Department of Psychiatry and Behavioral Sciences
Attending Psychiatrist, Pain & Palliative Care Service, Department of Neurology
Memorial Sloan-Kettering Cancer Center
Professor of Clinical Psychiatry, Department of Psychiatry
Weill Medical College of Cornell University
New York, New York
SHANNON R. POPPITO, PHD
Clinical Psychologist/Behavioral Health Consultant
Behavioral Health Optimization Program
Los Angeles Air Force Base
61st Medical Squadron
Los Angeles, California
1
1
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Library of Congress Cataloging-in-Publication Data
Breitbart, William, 1951- author.
Meaning-centered group psychotherapy for patients with advanced cancer : a treatment manual / William S. Breitbart,
Shannon R. Poppito.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–0–19–983725–0 (alk. paper) — ISBN 978–0–19–938067–1 (alk. paper)
I. Poppito, Shannon R., author. II. Title.
[DNLM: 1. Neoplasms—psychology. 2. Psychotherapy, Group—methods. 3. Depression--therapy. 4. Quality of Life.
5. Terminally Ill—psychology. QZ 200]
RC271.M4
616.99'40651—dc23
2013047207
This material is not intended to be, and should not be considered, a substitute for medical or other professional
advice. Treatment for the conditions described in this material is highly dependent on the individual circumstances.
And, while this material is designed to offer accurate information with respect to the subject matter covered and to be
current as of the time it was written, research and knowledge about medical and health issues is constantly evolving
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But if there is meaning,
it is unconditional meaning,
and neither suffering nor dying
can detract from it.
What our patients need is
an unconditional faith
in this unconditional meaning.
Viktor Frankl, The Will to Meaning (1969, p. 156)
The image on the title page is a carving that was created by a
meaning-centered psychotherapy study patient for his final “Legacy
Project.” It depicts his past, present, and future legacy intertwined
within the symbol of his Irish heritage and bound together by “eternal
love.”
Contents
Acknowledgments ix
Preface xi
Introduction: Meaning-Centered Group Psychotherapy
Treatment Overview for Therapists xxiii
Session 1. Concepts and Sources of
Meaning: Introductions and Meaning 1
Session 2. Cancer and Meaning: Identity before and
after Cancer Diagnosis 13
Session 3. Historical Sources of Meaning: “Life as a
Legacy” That Has Been Given 19
Session 4. Historical Sources of Meaning: “Life as a
Legacy” That One Lives and Will Give 25
Session 5. Attitudinal Sources of Meaning: Encountering
Life’s Limitations 31
Session 6. Creative Sources of Meaning: Creativity,
Courage, and Responsibility 39
Session 7. Experiential Sources of Meaning: Connecting
with Life through Love, Beauty, and
Humor 47
Session 8. Transitions: Final Group Reflections and
Hopes for the Future 55
References 61
Handouts 63
Homework/Experiential Exercises 71
Index 83
vii
Acknowledgments
We are indebted to our families for their love and support, and re-
member those precious to us, both family and patients, who have died
during the period of time we conducted the work reflected in this text.
We are indebted to our colleagues at Memorial Sloan-Kettering who
played central roles in the development and conduct of trials of both
meaning-centered psychotherapy (MCP) formats. Special thanks go to
Mindy Greenstein, Hayley Pessin, Barry Rosenfeld, Wendy Lichtenthal,
Allison Applebaum, and our many research collaborators, research assis-
tants, interventionists, pre- and postdoctoral fellows, and research man-
agers and coordinators.
We thank the National Institutes of Health, the National Cancer
Institute, the National Center for Complementary and Alternative
Medicine, the Fetzer Institute, and the Kohlberg Foundation, who pro-
vided funding for MCP clinical trials research.
Finally, our gratitude to the hundreds of patients who participated in
the clinical trials of MCP, and their devoted families and caregivers.
While most of the patients who participated in the clinical trials of
MCP are no longer with us, their legacies are alive and affect the course
and meaning of our lives in profound ways.
ix
