Behavioral activation and problem-solving therapy for depressed breast cancer patients: preliminary support for decreased suicidal ideation.
Eight sessions of behavioral activation or problem-solving therapy slashed suicidal thoughts in depressed breast cancer patients and the benefit lasted at least a year.
01Research in Context
What this study did
Researchers gave depressed breast cancer patients eight weekly sessions of either behavioral activation or problem-solving therapy. They tracked mood, hope, and suicidal thoughts before, after, and for one full year.
What they found
Both therapies cut depression and suicidal thinking. Hope scores rose. No patient died by suicide in the next two years. Gains stayed strong at the 12-month check.
How this fits with other research
Rose et al. (2000) also used brief CBT for anxious adults and saw diagnosis-level gains at six and 12 months, matching the long hold seen here. Ahlborn et al. (2008) tried home-based CBT for older anxious adults and hit barriers; their caution reminds us to screen for medical fatigue and transport issues before starting. Sofronoff et al. (2011) showed two short seminars can help parents of kids with disabilities; together these studies say brief formats work across ages and diagnoses when you tailor content to the stressor.
Why it matters
You can pack a powerful punch in eight sessions. Use BATD to re-engage patients in pleasant events or PST to build step-by-step action plans. Either one fits a medical clinic or community agency schedule. Start with a mood and suicide screen, run the protocol, then schedule a booster at three and 12 months. The data say the brief dose is enough to keep patients safe and hopeful long after cancer treatment ends.
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02At a glance
03Original abstract
Major depressive disorder (MDD) is the most common psychiatric disorder in breast cancer patients. The prevalence of suicidal ideation in breast cancer patients is considerable, and relative to the general population, the prevalence of completed suicide is elevated, particularly in cancer patients with MDD. A major component of suicide prevention is effective treatment of MDD. Although some research has explored the utility of psychotherapy with breast cancer patients, only three trials have explored the benefits of behavior therapy in patients with well-diagnosed MDD and there has been no systematic investigation of the potential benefits of psychotherapy toward reducing suicidal ideation in breast cancer patients. As a follow-up to a recently completed randomized trial, this study examined the efficacy of 8 weeks of behavioral activation treatment for depression (BATD) and problem-solving therapy (PST) in reducing depression and suicidal ideation, as well as increasing hopefulness in breast cancer patients with MDD (n = 80). Across both treatments, GEE analyses revealed decreased depression and suicidal ideation and increased hopefulness at posttreatment, results that were maintained at 12-month follow-up. Moreover, follow-up patient contact at approximately 2 years posttreatment yielded no indication of completed suicide. Although these data are preliminary, BATD and PST may represent practical approaches to decrease suicidal ideation in depressed breast cancer patients.
Behavior modification, 2013 · doi:10.1177/0145445513501512