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Life Review Therapy (Dear Memories Therapy)

Structured life review using autobiographical retrieval practice in palliative cancer patients 

 

Background
Patients with cancer in the palliative phase often experience feelings of reduced quality of life, sadness, hopelessness and spiritual distress, such as an evaluation of one’s past and problems with finding a new meaning in life while suffering from an incurable disease. There is an urgent need to evidence-based psychosocial intervention methods enhancing the quality of life and dying and relieving the emotional distress in palliative cancer patients in the daily practice of psychosocial care. Structured life review therapy seems to be an intervention appropriate to this need. 

The autobiographical retrieval practice ‘’Dear Memories’’ focuses on bringing up positive specific events. The protocol has shown to be effective in depressed older adults, and pilot studies suggested improved quality of life in depressed and non-depressed cancer-patients and in the general population. The intervention might help palliative cancer patients in mentally understanding their prognosis and their end of life. Retrieving positive memories seem to enhance feelings of mastery, enables re-thinking and re-evaluation of life events, and may contribute to reconstruct life including the diagnosis of cancer.

According to theories on the relationship between depression or distress and autobiographical memory depressed of sombre people have difficulties being specific in retrieving autobiographical memories. This protocol trains patients in retrieving specific positive autobiographical memories in order to improve the quality of life, reduce symptoms of depressed mood, and relieving the emotional distress

Relevance
In 2008 99603 Dutch people suffered from cancer, in that same year 40993 Dutch people died from this disease. A majority of cancer patients report emotional distress, a reduced quality of life, and they are having questions about life and meaning.

Objective
The goal of this study is to investigate the effectiveness of a structured life review protocol named ‘’Dear Memories’’ on enhancing quality of life in palliative cancer patients and their partners, via improving the autobiographical memory. We would like to investigate possible determinants of efficacy of the intervention, such as age, gender and cultural background. If the protocol appears to be an effective intervention, it can be introduced in the regular psycho-oncological care. Spouses of these included patients will be asked to participate to study a possible effect on their quality of life: although the intervention is targeting the patients, insight from earlier studies indicate that there may be a beneficial effect on spouses as well.

Methods
Study design: A multicenter prospective randomised control trial with two parallel groups. Patients are assigned to either an intervention condition; receiving the life review protocol immediately after premeasurement or to a waiting list condition, receiving care-as-usual and a follow-up measurement after one month to asses long-term effectiveness.
Study population: A sample of 150 cancer patients without curative treatment options with a prognosis of > 3 months will be included. Exclusion criteria are cognitive impairment, inability to communicate verbally, insufficient mastery of the Dutch language and psychotic symptoms or behaviour (delusions or hallucinations). 
Intervention: The intervention will be individually administered and consists of four weekly sessions, with every session focusing on a particular period in life – childhood, adolescence, adulthood and whole life span. For each period, 14 questions are prepared that are designed to prompt specific positive memories.  For example: ‘’What is the most pleasant situation that you remember from your childhood?” The interviewer tries to get a specific view of the situation by asking for more information. Patients receive feedback on how well they are doing in retrieving specific memories.
Main study parameters:  Primary outcomes are the specificity of Autobiographical Memory (AMT), quality of life (EORTC QLQ-PAL15), and ego-integrity (NEIS). Secondary outcomes regard depressive symptoms (HADS; MINI). Spouses are measured on level of depressive symptoms (HADS), personal growth (PTGI), and care giving burden (CRA).

METc
This project is approved by the Medical Ethical Committee, VU University Medical Center (VUmc).

Funding
ZonMw (2010 - 2015)

Staff
PhD student
G. Kleijn MSc., Researcher-Psychologist, dpt. of Clinical Psychology, VU Faculty of Psychology and Education.
Project leader
Prof. I.M. Verdonck-de Leeuw PhD, Psychologist, Speech and Language Therapist, Linguist, dpt. of Clinical Psychology, VU Faculty of Psychology and Education.
Project members
Prof.  W.J.M.J. Cuijpers PhD, Psychologist, dpt. of Clinical Psychology, VU Faculty of Psychology and Education.
Prof. C.R. Leemans MD PhD, Head and Neck Surgeon, dpt. of Otolaryngology-Head & Neck Surgery, VUmc.
Prof. R. De Bree, MD PhD, Head and Neck Surgeon, Vdpt. of Otolaryngology-Head & Neck Surgery, VUmc.
Prof. E.F. Smit, MD PhD, Pulmonary Specialist, dpt. of  Pulmonary Disease, VUmc.
A. Becker, MD PhD, Pulmonary Specialist, dpt. of  Pulmonary Disease, VUmc.
Prof. P. Huijgens, MD PhD, Hematologist, dpt. of Hematology, VUmc
C. Eeltink, MA RN, Nurse Practitioner, dpt. of Hematology, VUmc
D. Rietveld, MD, Radiotherapist, dpt. of Radiotherapy, VUmc
B. Steunenberg, PhD, Psychologist, University medical Center Utrecht (UMCU)
M. van den Brekel, MD PhD, Head and Neck Surgeon, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital
Drs. R. Fles,  Research technician, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital
Prof. E.T. Bohlmeijer, PhD, Psychologist, dpt. of Mental Health, University Twente,
V. Willemsen PhD, Psychologist, Ingeborg Douwes Center

Questions?
For questions, please contact:
Gitta Kleijn, MSc, Psychologist
Email: g.kleijn@vumc.nl
Phone: + 31( 0)20-5988782

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News flashes

 

Treatment of psychological distress in patients with head and neck or lung cancer cost-effective.
A recent study of PhD-student Femke Jansen and colleagues, recently published in the Journal of Clinical Oncology

 

PhD thesis Nadine Köhle

December 15, 2016 Nadine Köhle defended her PhD thesis "Hold on, for each other. Supporting partners of cancer patients via eHealth and positive psychology". 

 

PhD thesis Anne-Marie Krebber

December 2, 2016 Anne-Marie Krebber defended her PhD thesis "Stepped care targeting psychological distress in head and neck cancer and lung cancer patients".

 

PhD thesis Nadia van der Spek

September 7, 2016, Nadia van der Spek defended her PhD thesis "Meaning-centered group psychotherapy for cancer survivors: development, efficacy, and cost-utility". 

 

EORTC QLG Newsletter Spring 2016
The EORTC QLG  Spring Meeting took place on April 20th and 21th 2016 in Oslo. The Spring newsletter of the EORTC QLG is now available. 

PhD thesis Ingrid Cnossen

April 12, 2016, Ingrid Cnossen defended her PhD thesis entiteld “Self-management Supporting Rehabilitation in Head and Neck Cancer Patients”. 

 

VU/VUmc and Red-kite sign agreement for the provision of the Oncokompas in healthcare.

The VU University Amsterdam and VUmc Cancer Center Amsterdam work with Red-kite, distributor of software for hospitals in Netherlands. (November 3, 2015)

 

PhD thesis Christine van Gogh

December 4, 2015, Christine van Gogh defended her PhD thesis entiteld “Functional outcome of early glottic cancer”. 

Book presentation

On June 15th, 2015, Irma Verdonck presented the book "In Tune Without Cords" (in Dutch: VerderZonderStembanden) to Rob Burdorf, the president of the patient society for patients after laryngectomy.

 

PhD thesis Florien Boele

May 11 Florien Boele defended her PhD thesis, entitled "Towards improving health-related quality of life in glioma patients and their informal caregvers".

 

PhD thesis Trille Kristina Kjaer

May 8, Trille Kjaer will defend her PhD thesis entitled "Late effects after treatment of head and neck cancer and use of patient reported outcomes in clinical practice." Irma Verdonck is member of the committee.

 

Niels Stensen Fellowship
Florien Boele has received a Niels Stensen Fellowship. This is a scholarship that is awarded annually to a number of outstanding researchers who have recently obtained their PhD degree, to gain working experience abroad. Florien Boele will go to Pittsburgh (United States) and Edinburgh (Scotland) in 2015 and 2016.
 

Key paper

The publication “Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments” of A.M.H. Krebber et.al is chosen by the Editors as one of the key papers in Psycho-oncology, (issue June 2014).

 

On April 10th, 2014, the first edition of the Value Based Healthcare Prize took place. The prize for the most exceptional initiative in collaborations went to Jippa, a collaborative by VUmc, CZ, Radboud UMC and Tilburg University.

 

In November 2013 the NVPO organised the International Congress "Innovation in Psycho-Oncology". The researchgroup held several presentations and posters.

 

Interested in oncological care chain? Come 2 October 2013 to the 3rd MuON symposium in hospital Gelderse Vallei. Keynote speaker Michel van Schaik (Director Rabobank) about Innovation in the care!

 

12 april 2013: KWF Kankerbestrijding / Alpe d’HuZes has granted the research proposal Netherlands Quality of life and Biomedical Cohort Studies in Cancer (NET-QUBIC).

Marieke de Bruijn will defend her PhD thesis on 10 juni 2013 at 15.45 pm.

Support our bicycle team for Alpe d'HuZes 2013!

On 6 June 2013 our team living together with cancer will cycle the Alpe d'HuZes! This in the fight against cancer. At this moment there is already more than 1500 euro donated. Do you support us too?

 

The 15th World Congress of Psycho-Oncology and Psychosocial Academy will be held in Rotterdam, 4-8 November 2013. www.ipos-society.org/ipos2013/.

 

29 January 2013. Pink Ribbon has granted a project to develop and evaluate an online training for cancer patients with insomnia (Annemieke van Straten), and a project to develop and evaluate a breast cancer module for the OncoKompas (Nelly van Uden).

 

Charity Symposium "Living with cancer"

On December 19, 2012 there will be a Symposium ''Living with Cancer''. This is a charity symposium on meaning centered psychotherapy for cancer patients. Read more about it at the tab News at the left.

 

15 November 2012: Hoe?Zo! Radio interview with Irma Verdonck on stress and cancer.

 

October 2012: Interview with Irma Verdonck in Psychologie Magazine.

 

September 9, 2012. Interview Hans van Willigenburg with Irma Verdonck on Radio 5.

 

August 2012. Five students finish their MSc thesis and graduate as MSc in Clinical PSychology.

 

June 28-30, 2012: International symposium on Supportive Care in Cancer (MASCC ISOO) at New York. Kevin Yap and Irma Verdonck organise a workshop on e-health and supportive care.

 

Record for Alpe d'HuZes 2012. The sponsor action Alpe d'HuZes (6 and 7 June) 2012 has already yielded the record amount of 28.5 million euros.

 

June 6-8, 2012: Our research group contributes to Alpe d'HuZes as volunteers.

 

April 20, 2012: Nelly van Uden will give a presentation about OncoKompas at a conference about  ICT in health care in Barcelona.

 

March 16, 2012: NVPO congress in Utrecht, we contribute with 2 oral and 2 poster presentations and a workshop.

 

January 1, 2012: The project POLARIS project has officially started.

 

December 22, 2011: Radio program DeGids.fm, Felix Meurders interviews Corien Eeltink on sexuality and cancer. 

 

November 2, 2011: KWF / Alpe d'HuZes funds a grant for the development and evaluation of an online intervention for informal caregivers of cancer patients.

 

October 30, 2011 In the national television program "Gesprek op 2", Daphne Bunskoek interviewed Irma Verdonck on living with cancer.

 

October 28, 2011: www.oncokompas.nl is online!

 

October 23, 2011: Alpe d'HuZes hands over more than 20 million euros to the Dutch Cancer Society!

 

 

Team work

Our research projects are embedded in the two largest research institutes of VU University in Amsterdam: VUmc CCA-VICI (Cancer Center Amsterdam) www.vumc.nl/afdelingen/CCA-V-ICI/ and EMGO+ (Institute for Health and Care Research emgo.nl

We work closely with patients and their caregivers and with researchers and physicians at VU University and VU University Medical Center in Amsterdam and other research institutes and hospitals in the Netherlands and worldwide. Team work is crucial  improving research and translating results into clinical practice.

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