Coping Close to Home

Coping Close to Home

GSSW's Karen Kayser heading study to help couples deal with breast cancer

By Sean Smith
Chronicle Editor

Breast cancer patients benefit from individual and group counseling, says Assoc. Prof. Karen Kayser (GSSW), yet it is at home where the patient seeks her most important, and often overlooked, source of support.

"Research has shown that support from an intimate other is important for patients," said Kayser. "So it makes sense to cultivate the potential support which is already in your household."

Karen Kayser: "Most couples say they would never be able to talk this way at home. They don't know how to get started. They're afraid of adding an additional burden onto their partner." (Photo by Gary Gilbert)

But it is no easy task for couples to deal with the effects of breast cancer, she says. Even the most stable relationship can be affected by anxiety, fear and other emotions related to the disease, while concern for maintaining the family routine can further sap the couple's ability to communicate. Unfortunately, Kayser says, psychosocial services have rarely been available to help couples in these situations.

A study Kayser developed, now in its second year at three Boston hospitals, offers insights into the potential effectiveness of couples therapy. The study aims to track the progress of 100 couples, half of whom are enrolled in a program, "Partners in Coping," devised by Kayser to assist spouses and partners dealing with breast cancer.

Kayser says the program could serve as a model for hospitals or professionals in health care-related fields, especially clinical social workers. Using this approach enables couples to share their greatest fears, she says, and in doing so, to learn more about each other.

"Husbands and partners of breast cancer patients experience an equal or higher degree of emotional distress, which can greatly affect their ability to give the emotional support breast cancer patients value," she said. "This program is meant to address these related areas of need.

"One thing I've heard over and over is that this program provides a safe environment for a couple to talk about their experience in a structured way," she said. "Most couples say they would never be able to talk this way at home. They don't know how to get started. They're afraid of adding an additional burden onto their partner."

Funded through the Massachusetts Department of Public Health, the study is being undertaken at Dana-Farber Cancer Institute, Massachusetts General Hospital and Brigham and Women's Hospital. To be eligible, a woman must have been diagnosed with non-metastatic breast cancer within the previous three months, be receiving treatment, and be married or in an intimate relationship.

A patient and her spouse or partner are randomly assigned to one of two therapeutic options. In one, the couple attends nine private sessions with a clinical social worker trained in a treatment protocol covering specific topics related to coping with breast cancer. In the other, the couple is able to see a social worker who helps them with individual and family counseling as well as crisis management.

Kayser points out that the study is structured so all types of couples - whether young or old, childless or with children, or same-sex - can participate.

The social worker assigned to the couple follows a set of steps and guidelines to help build communication. For example, Kayser explains, he or she helps the couple take stock of the previous week, reviewing "ups and downs." They also explore a particular theme, starting with the more mundane details of a couple's home life - such as how they divide housework - and over time begin to discuss their intimacy and sexuality.

Other components in the program might include focusing on how the couple's children are reacting to the experience, or relaxation training.

Thirty couples have participated in the study so far, Kayser says, and many of those at or near completion of the program offered favorable comments. "Some women say they didn't realize their partner had the ability to give them the kind of support they needed," she said.

More information on the program is available /breastcancercoping  

Return to November 2 menu

Return to Chronicle home page