A couples intervention for patients facing advanced cancer and their spouse caregivers: outcomes of a pilot study

The primary objective of this study was to evaluate the effectiveness of a couples intervention in improving marital functioning in advanced cancer patients and their spouse caregivers. A secondary objective was to determine its impact on other symptoms of psychosocial distress and its feasibility and acceptability as a clinical intervention.

Using a one-arm pre- and post-intervention prospective design, 16 couples were provided 8 weekly sessions of Emotionally Focused Couple Therapy, modified and manualized for the cancer population. Subjects' marital functioning (Revised Dyadic Adjustment Scale [RDAS]), symptoms of depression (Beck Depression Inventory-II [BDI-II]), and hopelessness (Beck Hopelessness Scale) were assessed through self-report at T0 (baseline), T1 (after four sessions), T2 (after eight sessions), and T3 (3 months post-intervention follow-up).

RDAS scores improved from T0 to T2, with 87.5% of the couples showing some improvement (0.5-5 points) or significant improvement (>5 points) in marital functioning and 68.8% scoring in the non-distressed range (>or=48 RDAS). At T3, 60% of the couples (n=15) continued to score in the non-distressed range on the RDAS. BDI-II scores were significantly higher for patients than for caregivers. There was a significant reduction in the mean BDI-II score from T0 to T3 in all subjects (n=30). This reduction was more significant for the patients (n=15).

Providing support to couples at this challenging time may result in improved marital functioning and an opportunity for relational growth during end-stage cancer. This study serves as the first step in the development of an empirically validated intervention for couples.