The range of effects of psychosocial interventions on quality of life among women with breast cancer remains uncertain. Furthermore, it is unclear which components of multimodal interventions account for such effects. To address these issues, the authors tested a 10-week group cognitive-behavioral stress management intervention among 199 women newly treated for nonmetastatic breast cancer, following them for 1 year after recruitment. The intervention reduced reports of social disruption and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect for up to 12 months (indeed, some effects strengthened over time). With respect to mechanisms tested, the intervention increased confidence in being able to relax at will. There was also evidence that effects of the intervention on the various outcomes examined were mediated by change in confidence about being able to relax.Correspondence concerning this article should be addressed to Michael H. Antoni, Department of Psychology, University of Miami, 5665 Ponce De Leon Boulevard, Coral Gables, FL 33146. mantoni@miami.edu. HHS Public AccessAuthor manuscript J Consult Clin Psychol. Author manuscript; available in PMC 2018 January 03. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThus, this intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention.Keywords breast cancer; stress management; relaxation training; quality of life Treatment of breast cancer requires significant psychosocial adaptation (Irvine, Brown, Crooks, Roberts, & Browne, 1991; van't Spijker, Trijsburg, Duivenvoorden, 1997). Symptoms of depression and anxiety are common, along with reports of subjective stress and decrements in sexual and interpersonal functioning (Andrykowski, Cordova, Studts, & Miller, 1998;Carver, Lehman, & Antoni, 2003;Schag et al., 1993; Wimberly, Carver, Laurenceau, Harris, & Antoni, 2005). Conversely, the experience of breast cancer is not wholly negative; many women perceive benefits (as well as threats) in the experience (Taylor, 1983). These include improved personal resources and skills, an enhanced sense of purpose, enhanced spirituality, closer ties to others, and changes in life priorities, collectively termed benefit finding (Lechner & Antoni, 2004; Tomich & Helgeson, 2004).Many factors have been identified as sources of resiliency among women with breast cancer -variables that buffer negative experiences or foster positive ones (Carver, 2005a). Such factors as optimism, effective coping strategies, and social support from one's spouse or family members yield fewer negative and more positive experiences during treatment and beyond (Alferi, Carver, Antoni, Weiss, & Duran, 2001;Carver et al., 1993;Stanton, Kirk, Cameron, & Danoff-Burg, 2000;Carver et al., 2005). Such work provides a blueprint for psychosocial interventions to enhance resiliency fac...

Objective-After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention.Method-A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment.Results-The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy.Conclusions-Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer.Approximately 216,000 new cases of breast cancer were diagnosed in the United States in 2004 (1). Diagnosis and treatment of breast cancer are clearly stressful events (2) involving invasive medical procedures with aversive side effects of treatment such as pain, nausea, vomiting, and fatigue (3). Recurring thoughts about the diagnosis and treatment are common (4). Although diagnostic levels of posttraumatic stress disorder (PTSD) are relatively rare (5), PTSD-like symptoms and subthreshold levels of PTSD are more frequent (6, 7). After Address correspondence and reprint requests to Dr. Antoni, Department of Psychology, 5665 Ponce DeLeon Blvd., University of Miami, Coral Gables, FL 33124-0751; MAntoni@miami.edu. Dr. Antoni reports that he is the author of a book that details the intervention discussed in the article which is published by the American Psychological Association. The other authors report no competing interests. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscript treatment, many survivors experience residual psychological strain from the diagnosis, shifts in social support, fear of recurrence, and fear of death (8).Factors that influence distress after breast cancer treatment include coping style and social support (6,9,10). Prospective studies reveal that optimism (11), coping strategies such as positive reframing and acceptance (11,12), and social support (13) yield less distress in the months after treatment. Similarly, psychosocial interventions that foster optimistic appraisals, build coping strategies, and bolster social support should benefit women treated for breast cancer (14).Psychosocial interventions for persons with cancer and other chronic illnesses typically use cognitive behavior techniques, often incorporating skills training an...

The range of effects of psychosocial interventions on quality of life among women with breast cancer remains uncertain. Furthermore, it is unclear which components of multimodal interventions account for such effects. To address these issues, the authors tested a 10-week group cognitive-behavioral stress management intervention among 199 women newly treated for nonmetastatic breast cancer, following them for 1 year after recruitment. The intervention reduced reports of social disruption and increased emotional well-being, positive states of mind, benefit finding, positive lifestyle change, and positive affect for up to 12 months (indeed, some effects strengthened over time). With respect to mechanisms tested, the intervention increased confidence in being able to relax at will. There was also evidence that effects of the intervention on the various outcomes examined were mediated by change in confidence about being able to relax.Correspondence concerning this article should be addressed to Michael H. Antoni, Department of Psychology, University of Miami, 5665 Ponce De Leon Boulevard, Coral Gables, FL 33146. mantoni@miami.edu. HHS Public AccessAuthor manuscript J Consult Clin Psychol. Author manuscript; available in PMC 2018 January 03. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptThus, this intervention had beneficial effects on diverse aspects of quality of life after treatment for breast cancer, which appear linked to a specific stress management skill taught in the intervention.Keywords breast cancer; stress management; relaxation training; quality of life Treatment of breast cancer requires significant psychosocial adaptation (Irvine, Brown, Crooks, Roberts, & Browne, 1991; van't Spijker, Trijsburg, Duivenvoorden, 1997). Symptoms of depression and anxiety are common, along with reports of subjective stress and decrements in sexual and interpersonal functioning (Andrykowski, Cordova, Studts, & Miller, 1998;Carver, Lehman, & Antoni, 2003;Schag et al., 1993; Wimberly, Carver, Laurenceau, Harris, & Antoni, 2005). Conversely, the experience of breast cancer is not wholly negative; many women perceive benefits (as well as threats) in the experience (Taylor, 1983). These include improved personal resources and skills, an enhanced sense of purpose, enhanced spirituality, closer ties to others, and changes in life priorities, collectively termed benefit finding (Lechner & Antoni, 2004; Tomich & Helgeson, 2004).Many factors have been identified as sources of resiliency among women with breast cancer -variables that buffer negative experiences or foster positive ones (Carver, 2005a). Such factors as optimism, effective coping strategies, and social support from one's spouse or family members yield fewer negative and more positive experiences during treatment and beyond (Alferi, Carver, Antoni, Weiss, & Duran, 2001;Carver et al., 1993;Stanton, Kirk, Cameron, & Danoff-Burg, 2000;Carver et al., 2005). Such work provides a blueprint for psychosocial interventions to enhance resiliency fac...

The occurrence and impact of terrorist attacks can be dramatic and long lasting. Cognitive-behavioral interventions are effective in alleviating posttraumatic stress disorder (PTSD) in survivors of rape, wartime combat, automobile accidents, and natural disasters. Effectiveness of such interventions on victims of terrorist attacks is in the early stages of research. On September 11, 2001, two hijacked planes crashed into the twin towers in New York City, killing approximately 2,750 people and emotionally and physically affecting thousands who witnessed or escaped the attack. This case study illustrates a course of 12 active prolonged exposure (PE) sessions for PTSD with a female survivor. After 15 sessions (3 of which were preparatory), the client improved 75%, as measured by a composite score of measures. Her reported quality of life had improved dramatically posttreatment and remained stable at 6-month follow-up. This cognitive-behavioral therapy intervention, with 15 office sessions and homework assignments for decreasing avoidances, is described and discussed.