Why is Meaning-Centered Group Psychotherapy (MCGP) effective? Enhanced sense of meaning as the mechanism of change for advanced cancer patients.

OBJECTIVES: Meaning-Centered Group Psychotherapy (MCGP) has been demonstrated to be an effective method for improving advanced cancer patients' quality of life and reducing their depression, hopelessness, and desire for hastened death. To further understand MCGP, this study examined the mechanisms of change in MCGP on these outcomes via advanced cancer patients' changes of sense of meaning and peace in life.

METHODS: The sample data were from 2 randomized control trials that compared MCGP (n = 124) to supportive group psychotherapy (n = 94). Mediation effects of treatment status on outcomes (2 months after completion of treatment) via patients' change in sense of meaning and peace (posttreatment minus pretreatment) were tested. The outcome variables used in these analyses were quality of life, depression, hopelessness, and desire for hastened death.

RESULTS: Significant mediation effects via change in sense of meaning and peace on these outcomes were found. Consistent results were found using intention-to-treated statuses. Weaker, but still significant, mediation effects via change in sense of faith on these outcomes were also found.

CONCLUSIONS: Results supported the hypotheses that improvement due to MCGP is mediated by advanced cancer patients' enhanced sense of meaning. These findings highlight the importance of interventions focused on enhancing sense of meaning, as this appears to be a viable route to improve quality of life and decrease psychological distress among patients with advanced cancer.