Interventions to Promote Resilience in Cancer Patients

Resilience is the ability to maintain or rapidly regain mental health during or after stressful life experiences. Cancer is a major risk factor for stress- associated mental illness. In this review, we attempt to identify effective resilience- promoting interventions in adults with cancer.

The analysis was restricted to randomized, controlled trials of resilience- promoting interventions in adults with cancer in which training was provided for at least one psychosocial resilience factor. A selective search, with systematic compo- nents, for relevant publications was carried out in the PubMed and CENTRAL data- bases. Effect sizes (Hedges' g) were calculated wherever a fully reported dataset for resilience or post-traumatic growth was available.

Twenty-two trials with a total of 2,912 patients were included in the analy- sis; the intervention was provided in an individual setting in five trials and in group format in 17. Beneficial effects on resilience and post-traumatic growth, some of them large, were observed in patients who were acutely ill with cancer and after in- terventions that were provided in more than 12 sessions. The effect size ranged from g = 0.33 to g = 1.45. Largely beneficial effects were achieved by interventions based on the concepts of positive psychology, supportive-expressive group therapy, behavioral therapy, or mindfulness, with considerable variation in individual effect sizes.

Interventions that promote resilience should be made available to inter- ested and motivated cancer patients. These interventions should be provided, in as soon as the diagnosis is made and should ex- tend over more than 12 sessions whenever possible.