Open Access Study protocol

Effectiveness and cost-effectiveness of meaning-centered group psychotherapy in cancer survivors: protocol of a randomized controlled trial

Nadia van der Spek1, Joël Vos23, Cornelia F van Uden-Kraan14, William Breitbart5, Pim Cuijpers1, Kitty Knipscheer-Kuipers6, Vincent Willemsen6, Rob AEM Tollenaar7, Christi J van Asperen3 and Irma M Verdonck-de Leeuw14*

Author Affiliations

1 Department of Clinical Psychology, VU University, VdBoechorststraat 1, room 2B-64, Amsterdam 1081 BT, The Netherlands

2 Department of Psychology, University of Roehampton, London, UK

3 Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands

4 Department of Otolaryngology - Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands

5 Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, USA

6 Ingeborg Douwes Centrum, Center for psychological care for cancer patients, Amsterdam, The Netherlands

7 Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

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BMC Psychiatry 2014, 14:22  doi:10.1186/1471-244X-14-22

Published: 28 January 2014



Meaning-focused coping may be at the core of adequate adjustment to life after cancer. Cancer survivors who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning. Meaning-Centered Group Psychotherapy for Cancer Survivors (MCGP-CS) was designed to help patients to sustain or enhance a sense of meaning and purpose in their lives. The aim of the proposed study is to evaluate the effectiveness and cost-effectiveness of MCGP-CS.


Survivors diagnosed with cancer in the last 5 years and treated with curative intent, are recruited via several hospitals in the Netherlands. After screening, 168 survivors are randomly assigned to one of the three study arms: 1. Meaning-Centered Group Psychotherapy (MCGP-CS) 2. Supportive group psychotherapy (SGP) 3. Care as usual (CAU). Baseline assessment takes place before randomisation, with follow up assessments post-intervention and at 3, 6 and 12 months follow-up. Primary outcome is meaning making (PMP, PTGI, SPWB). Secondary outcome measures address quality of life (EORTC-30), anxiety and depression (HADS), hopelessness (BHS), optimism (LOT-R), adjustment to cancer (MAC), and costs (TIC-P, EQ-5D, PRODISQ).


Meaning-focused coping is key to adjustment to life after cancer, however, there is a lack of evidence based psychological interventions in this area. Many cancer survivors experience feelings of loneliness and alienation, and have a need for peer support, therefore a group method in particular, can be beneficial for sustaining or enhancing a sense of meaning. If this MCGP-CS is effective for cancer survivors, it can be implemented in the practice of psycho-oncology care.

Trial registration

Netherlands Trial Register, NTR3571

Cancer; Survivorship; Meaning; Psycho-oncology; Existential distress; Group psychotherapy; Effectiveness; Cost-effectiveness