Managing Cancer and Living Meaningfully (CALM) Therapy

Abstract

AbstractManaging cancer and living meaningfully (CALM) is a brief, semi-structured individual and couple-based intervention designed to alleviate distress and promote well-being in individuals living with advanced cancer. CALM emerged from a longitudinal program of research and the theoretical traditions of relational, attachment, and existential theory. Through a therapeutic process that supports affect regulation, attachment security, and reflective functioning, CALM addresses four content domains: symptom management and communication with healthcare providers; changes in self and relations with close others; spiritual well-being, sense of meaning and purpose; and preparing for the future, sustaining hope, and facing mortality. Caregivers are invited to participate to provide an additional perspective and help address strains and strengths in the spousal relationship, the impact of the illness on the family, and planning for the future. Qualitative research demonstrates that CALM provides the experience of a safe place to explore fears, feel more fully seen in human terms, and face the challenges and threats of advancing disease. Quantitative research demonstrates that CALM is effective in reducing and preventing depressive symptoms, alleviating death anxiety, and facilitating communication of patients with healthcare providers, preparation for the end of life, and clarification of feelings and values. Healthcare providers from multiple disciplines in more than 20 countries have been successfully trained in CALM through didactic and experiential workshops and ongoing supervision. The semi-structured nature of CALM has allowed its adaptation and delivery in diverse cultural and clinical contexts.