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A feasibility study of affect-focused psychodynamic psychotherapy for mothers diagnosed with cancer
Uppsala University, WoMHeR (Centre for Women’s Mental Health during the Reproductive Lifespan). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Medical psychology and care science.ORCID iD: 0000-0003-4230-702x
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Medical psychology and care science.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Medical psychology and care science.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Cancer Immunotherapy.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Mothers diagnosed with cancer experience significant psychological distress, affecting both their own and their families’ well-being. Despite high support needs, easily accessed psychological support remains limited. Affect-focused psychodynamic psychotherapy (AFT) has been shown effective in improving psychological well-being but has not been studied in this population.

Purpose: To test the feasibility, acceptability, safety and preliminary effects of online delivered AFT among parents with cancer.

Methods: This feasibility study included qualitative interviews analysed with inductive content analysis to assess feasibility, acceptability and safety, and quantitative pre- and post-intervention assessments of changes in mental health outcomes using questionnaires. Primary outcomes were symptoms of depression and anxiety. Secondary outcomes were parenting concerns, emotion regulation, affect-phobia, self-efficacy, closeness in the family, and self-rated health.

Results: The qualitative findings highlighted key factors concerning the conditions of participation, the content of the intervention and the perceived effects. The quantitative results indicated improvements in depression, anxiety, as well as in all secondary outcomes but one subscale of emotion regulation.

Conclusions: Findings suggest that online delivered AFT is feasible, acceptable, and safe for mothers diagnosed with cancer, and promising in terms of improvement in several aspects of psychological function. 

Implications: Online delivered AFT may provide accessible and effective psychological support for mothers diagnosed with cancer, addressing an important gap in routine cancer care. To confirm efficacy and explore the long-term effects, randomised controlled trials with larger and more heterogeneous samples should be conducted. Further studies also need to explore factors related to optimising implementation in clinical settings.

Keywords [en]
Neoplasms, parenting, psychological interventions, psychodynamic therapy, affect-focused psychotherapy
National Category
Cancer and Oncology Applied Psychology
Identifiers
URN: urn:nbn:se:uu:diva-554972OAI: oai:DiVA.org:uu-554972DiVA, id: diva2:1953324
Available from: 2025-04-20 Created: 2025-04-20 Last updated: 2025-04-20
In thesis
1. Navigating parenting and cancer: Understanding parenting concerns, challenges, and supporting psychological well-being in parents with cancer
Open this publication in new window or tab >>Navigating parenting and cancer: Understanding parenting concerns, challenges, and supporting psychological well-being in parents with cancer
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many adults diagnosed with cancer are parents of dependent children. Balancing the roles of a patient and a parent is a stressor, with parenting concerns linked to elevated psychological distress. Despite this, the psychosocial support needs of parents with cancer are oftentimes not met. Addressing these gaps in support is essential to promote the psychological well-being of both parents and their families.

The overall aim of this thesis was to explore parenting concerns, challenges, and psychological distress among parents with cancer, assess psychosocial support needs, and evaluate the feasibility of a psychological intervention for parents. First, a systematic review was conducted to identify existing psychosocial interventions for parents with cancer (study I). Then, parents’ experiences and challenges in relation to cancer was explored in interviews (study II), and a cross-sectional survey examined levels of psychological distress and associated factors, including parenting concerns, self-efficacy, and emotion regulation (study III). A psychometric evaluation assessed the Swedish version of the Parenting Concerns Questionnaire (PCQ, study IV), and finally, a pilot study of online affect-focused psychodynamic psychotherapy for parents explored its feasibility, acceptability, safety and preliminary effects (study V).

The findings show that parenting concerns are central in parents’ lives. Study I identified 22 psychosocial interventions, some of which were promising but most were not formally evaluated. Study II highlighted the difficulties being both a parent and a patient, and how cancer impacted parenting and roles in the family. Parenting could serve as a source of stress or resilience. In study III, one in three parents reported symptoms above cut-off for depression, anxiety, or stress, and 16% experienced all three. Higher parenting concerns, low self-efficacy, and maladaptive emotion regulation were associated with increased psychological distress. Study IV assessed the Parenting Concerns Questionnaire (PCQ) as valid and reliable overall. In study V, affect-focused psychodynamic psychotherapy (AFT) was experienced as feasible, relevant, and beneficial in reducing psychological distress.

This thesis underscores that parenting with cancer reflects a complex interplay of individual, relational, and structural factors, highlighting the need for holistic psychosocial support that acknowledges parents not only as patients but as part of a family.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2025. p. 107
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 2155
Keywords
Neoplasms, cancer, parenting, parenting concerns, psychological distress, psychological interventions
National Category
Cancer and Oncology Applied Psychology
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-554977 (URN)978-91-513-2493-7 (ISBN)
Public defence
2025-06-12, Sal IV, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2025-05-22 Created: 2025-04-20 Last updated: 2025-05-22

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Romare Strandh, MariaLjungman, LisaWikman, Anna

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WoMHeR (Centre for Women’s Mental Health during the Reproductive Lifespan)Medical psychology and care scienceCancer ImmunotherapyDepartment of Women's and Children's HealthCancer precision medicine
Cancer and OncologyApplied Psychology

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