Dr David Spiegel outlined the goals of supportive-expressive group therapy (SEGT) in his book Group Therapy for Cancer Patients published in 2000 by Basic Books. Dr Spiegel, Stanford University, pioneered the use of SEGT with women with breast cancer and is the model we use for the group. Goals include:
Overcoming isolation – like Margaret, many women have not met anyone with secondary breast cancer before their diagnosis, so being part of a group helps women feel less alone.
Expressing emotion- some feelings like fear, anger and grief are difficult to express and may be confronting for others. Being able to ‘speak the words’ with others who understand can be a great relief and also helps clarify what you can and can’t change. Whereas avoidance of painful feelings can lead to increased anxiety and distress.
Detoxifying death and dying – most of us find it difficult to think about our own mortality but when you have a life threatening illness you are confronted with it on a daily basis. When women are helped to face their fears about dying, they are free to get on with the business of living and thinking about how they want to spend the rest of their lives.
Redefining life’s priorities – when women realise that their lives will be shortened by the illness, their priorities change. For some it is a spur to realising long held ambitions. It makes women decide what really matters to them. Facing their diagnosis enables women to make choices and they feel more empowered by doing so.
Increasing the support of family and friends – Having cancer tests the quality of one’s relationships. Women talk of finding out who their true friends are. By helping family and friends to provide genuine support and not avoid talking about death, the group strengthens relationships and helps women feel less alone and frightened.
Improving the doctor-patient relationship – Women become active participants in their treatment through their involvement in the group. The group encourages women to ask questions, be informed about their treatment and to communicate clearly their needs and wishes.