Meaning-centred psychotherapy

Domain III · Humanistic, existential & experiential · William Breitbart, Shannon Poppito · 2014 · New York

What it is

MCP is a brief, manualised, largely psychoeducational and experiential psychotherapy developed by William Breitbart and colleagues (Shannon Poppito co-author of the manuals) at MSK, New York, for patients with advanced cancer who experience existential distress: loss of meaning, hopelessness,…

Format

• MCGP: 8 weekly sessions of about 1.5 hours (some descriptions say up to 2 hours), groups of roughly 6–8 patients, one or two trained leaders.
• IMCP: 7 weekly sessions of about 60 minutes. Window of about 14 weeks allowed so illness-related gaps (fortnightly sessions) do not end treatment; telephone or teleconference sessions permitted for hospitalised or very ill patients at the clinician's discretion.

Who practises it, and how they are trained or regulated

• Format

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Conflicting needs of patient and caregiver; give each space.
• Dyspnoea or pain making breath focus uncomfortable; offer an eyes-open alternative.
• Fatigue and cognitive effects of treatment; keep tasks short and optional. Working sign: patient brings examples from the week.
• Anhedonia (check for depression); isolation (problem-solve contact). Working sign: patient reports savouring daily moments (walks, meals with a partner).
• Grief at ending, or members who have died or deteriorated during the group; name losses openly. Working sign: hope reframed (e.g. from cure to meaningful time).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.