Short-term Psychodynamic Psychotherapy in Serious Physical Illness (ORPHYS)

Universitätsklinikum Hamburg-Eppendorf

Status: Active, not recruiting

Conditions: Malignant Neoplasm; Carcinoma; Palliative Care

Treatments: Behavioral: Short-term psychodynamic psychotherapy for patients with serious physical illness (ORPHYS)

Study type: Interventional

Funder types: Other

Identifiers

NCT05520281

DKH70113404-2

Details and patient eligibility

About

Life-threatening physical illness may powerfully re-activate existential conflict. There is little evidence to date on the effectiveness of relationship-focused therapies in this patient group.The aim of this study is to pilot a psychodynamic treatment for patients with advanced cancer and high psychological distress.

Full description

Severely physically ill patients may experience existential distress symptoms including helplessness, hopelessness, death anxiety, perceived burdensomeness and a sense of pointlessness. The latter can significantly interfere with end-of-life care processes and outcomes (receipt of treatment according to preferences, expression of desire for hastened death). So far, empirically tested psychotherapeutic programs in advanced life-threatening illness have predominantly been ultra-short and applied supportive and resource-oriented techniques. Psychodynamic treatment allows to address clinically significant existential distress through its conceptualization from early relational life experiences.

The aim of this study is to pilot a psychodynamic treatment for patients with advanced cancer and high psychological distress.The inverstigators will

1. analyse the feasibility of the treatment, and
2. investigate changes in process- and patient-relevant outcomes over the course of the treatment

The inverstigators will conduct a single-group pre-post study with five assessment points in which 50 adult patients diagnosed with advanced cancer will receive a manualized psychodynamic short-term therapy. Target parameters are assessed by diagnostic interviews, focus interviews, self-assessment questionnaires as well as electronic patient records. For research objective b) the investigators will compare the intervention group with a matched comparison group of a longitudinal cohort sample (NCT04600206). Matching will be based on stress level, demographic, and medical parameters across the 5 assessment points.

Enrollment: 50 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 18 years and older
• UICC stage IV solid tumor
• Informed consent
• Current physical condition that allows for at least 12 therapy sessions
• Indication: Presence of a mental disorder with existential stress and limitations in coping capacity

Exclusion criteria

• Acute suicidality
• Psychotic disorder (ICD-10: F2 diagnosis)
• Substance dependence or abuse (ICD-10: F1 diagnosis)
• Structural deficits that interfere with attending to regular appointments
• Other psychotherapeutic treatment
• Severe cognitive impairment
• Severe physical impairment
• Insufficient German to give informed consent and complete self-report questionnaires

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

50 participants in 1 patient group

Patients

Experimental group

Description:

Adult patients across all phases of advanced disease (UICC stage IV solid tumor) from diagnosis to terminal stages

Treatment:

Behavioral: Short-term psychodynamic psychotherapy for patients with serious physical illness (ORPHYS)