Cognitive-existential group therapy

Domain III · Humanistic, existential & experiential · Kissane, Bloch, Miach · 1997 · Melbourne

What it is

CEGT is a time-limited, manualised, therapist-led group therapy for people with early-stage (curable-intent) cancer. It joins two strands: (a) cognitive-behavioural coping skills (formal problem-solving and restructuring of negative automatic thoughts) and (b) existential group work on the real…

Format

• Dose and format: 20 weekly group sessions of 90 minutes over about six months; three additional relaxation classes (progressive muscle relaxation with guided imagery; about 50 minutes each in the trial).
• Six goals (these are the organising "tasks" of the group): 1) create a supportive environment; 2) facilitate grief over multiple losses; 3) alter maladaptive cognitive patterns; 4) improve problem-solving and coping skills; 5) foster a sense of mastery (Nakamura & Kawase summarise this goal set as…

Who practises it, and how they are trained or regulated

• [FCR adaptation] Lebel/Maheu cognitive-existential FCR intervention: 6 weekly sessions (reported as 90 minutes, with one mention of 120 minutes in the group version); groups of 5–8 women with breast or ovarian cancer; an individual version runs 60–90 minutes per session. Session sequence: 1) introduction, FCR model, triggers, cognitive restructuring, progressive muscle relaxation; 2) control and self-talk; 3) worry;…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• 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?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• self-talk that is false reassurance ("It will never come back"). Working when self-talk is believable and used.
• false reassurance; members comparing "good" and "bad" copers. Working when members describe themselves as more capable.
• blame without action; family violence or high conflict needing separate help. Working when members report clearer communication.
• demoralisation shading into depression or suicidal thoughts (assess). Working when members commit to specific valued activities.
• pressure to find a "gift" in cancer; plans that ignore ongoing fatigue. Working when goals are concrete and personally meaningful.

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.