Meaning-Making and Psychological Adjustment to Cancer: Development of an Intervention and Pilot Results

A lthough only a third of patients with cancer experience severe psychological distress (Derogatis et al., 1983; Farber, Weinerman, & Kuypers, 1984; Stefanek, Derogatis, & Shaw, 1987; Zabora, Brintzenhofeszoc, Curbow, Hooker, & Piantadosi, 2001), guidelines for the delivery of optimal comprehensive cancer care are based on the premise that every patient at every stage of the disease experiences some degree of psychological discomfort (Council of the Canadian Strategy for Cancer Control, 2004; Holland, 1999, 2000). Existential distress, defi ned as the state of an individual confronting his or her own mortality arising from feelings of powerlessness, disappointment, futility, meaninglessness, remorse, death anxiety, and disruption with his or her engagement with and purpose in life (Kissane, 2000), appears to be a ubiquitous part of the cancer experience. Meaning-making coping increasingly is recognized as a possible mechanism by which existential concerns can be addressed (Coward, 1998, 2003; Folkman & Greer, 2000; Lee, Cohen, Edgar, Laizner, & Gagnon, 2004; Mullen, Smith, & Hill, 1993; Taylor, 2000).