Couples Therapy to Enhance Intimacy Between Patients With Advanced or Recurrent Prostate Cancer and Their Partners

• Feasibility of Intimacy-Enhancing Couples Therapy (IECT) (e.g., eligibility rate, acceptance rate, attendance rate, satisfaction) assessed at baseline and at 1 month after completion of study intervention [ Time Frame: 2 years ] [ Designated as safety issue: No ]
• Comparison of the preliminary effect of IECT vs usual care on global psychological distress and relationship intimacy as assessed by the BSI-18 at baseline and at 1 month after completion of study intervention [ Time Frame: 2 years ] [ Designated as safety issue: No ]
• Relationship functioning, including intimacy, communication, and satisfaction (cancer-specific and overall) as assessed by the CRCS and A-DAS at baseline and at 1 month after completion of study intervention [ Time Frame: 2 years ] [ Designated as safety issue: No ]

• Feasibility of Intimacy-Enhancing Couples Therapy (IECT) (e.g., eligibility rate, acceptance rate, attendance rate, satisfaction) assessed at baseline and at 1 and 4 months after completion of study intervention
• Comparison of the preliminary effect of IECT vs usual care on global psychological distress and relationship intimacy as assessed by the BSI-18 at baseline and at 1 and 4 months after completion of study intervention
• Relationship functioning, including intimacy, communication, and satisfaction (cancer-specific and overall) as assessed by the CRCS and A-DAS at baseline and at 1 and 4 months after completion of study intervention

RATIONALE: A couples therapy program may enhance intimacy and reduce psychological distress in patients with prostate cancer and in their partners.

PURPOSE: This randomized clinical trial is studying how well couples therapy enhances intimacy and reduces psychological distress in patients with advanced or recurrent prostate cancer and in their partners.

OBJECTIVES:

• Determine the feasibility of Intimacy-Enhancing Couples Therapy (IECT) for patients with advanced or recurrent prostate cancer and their partners.
• Compare the effect of IECT vs usual care on patients' and their partners' level of global psychological distress.
• Compare the effect of IECT vs usual care on relationship intimacy in these participants.

OUTLINE: This is a randomized, controlled, pilot, multicenter study. Patients are stratified according to marital distress based on partners' scores on the Abbreviated Dyadic Adjustment Scale (high [< 21] vs low [≥ 21]). Patients and their partners are randomized to 1 of 2 arms.

• Arm I: Patients and their partners receive Intimacy-Enhancing Couples Therapy over 6 weeks comprising the following four 90-minute sessions: the Story of Cancer; Understanding the Couple, Ways of Relating and Key Influences; Intimacy; and Coping, Support, and Adaptation. Patients and their partners complete treatment satisfaction questionnaires after completion of study intervention.
• Arm II: Patients and their partners receive standard psychosocial care. All participants complete questionnaires assessing psychological distress, intimacy, communication patterns, and overall relationship adjustment/satisfaction at baseline and at 1 month after completion of study intervention.

• Prostate Cancer
• Psychosocial Effects of Cancer and Its Treatment
• Sexual Dysfunction
• Sexuality and Reproductive Issues

• Other: counseling intervention
• Other: questionnaire administration
• Procedure: psychosocial assessment and care

• Experimental: Intimacy-Enhancing Couples Therapy
  Patients and their partners receive Intimacy-Enhancing Couples Therapy over 6 weeks comprising the following four 90-minute sessions: the Story of Cancer; Understanding the Couple, Ways of Relating and Key Influences; Intimacy; and Coping, Support, and Adaptation. Patients and their partners complete treatment satisfaction questionnaires after completion of study intervention.
  Interventions:

  • Other: counseling intervention
  • Other: questionnaire administration
  • Procedure: psychosocial assessment and care
• Active Comparator: standard psychosocial care
  Patients and their partners receive standard psychosocial care. All participants complete questionnaires assessing psychological distress, intimacy, communication patterns, and overall relationship adjustment/satisfaction at baseline and at 1 month after completion of study intervention
  Interventions:

  • Other: questionnaire administration
  • Procedure: psychosocial assessment and care

DISEASE CHARACTERISTICS:

• Diagnosis of primary prostate cancer

  • Advanced or recurrent disease
• Receiving concurrent hormonal therapy
• Married and/or co-habitating with a partner for ≥ 1 year
• T-score > 50 on Brief Symptom Inventory-18 questionnaire (patient and/or partner)

PATIENT CHARACTERISTICS:

• Normal cognitive functioning
• Able to speak and read English
• No significant hearing impairment that would preclude study participation

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics

• National Cancer Institute (NCI)
• Fox Chase Cancer Center