An investigation of the outcomes of psycho-oncology interventions : a thesis presented as partial fulfilment of the requirements for the degree of Doctorate in Clinical Psychology at Massey University, Wellington, New Zealand

Cancer can have a significant psychological impact on those diagnosed, and their families. The ability of psychotherapy to reduce this impact has been extensively studied internationally. However, New Zealand-based research in this area remains limited. The present study aimed to investigate the effectiveness of psycho-oncology interventions, provided by a New Zealand psycho-oncology service, in reducing distress and improving quality of life for cancer patients and their families/whanau. Eighteen clients (patients/family members) of the service (intervention group) were recruited and matched for initial distress and wellbeing with patients/family members located in an area without a psycho-oncology service (control group). Wellbeing, wairua (spirituality), distress, impact and coping were measured pre- and posttherapy, and at follow-up. In addition, eight intervention group participants were interviewed to examine their experiences of cancer and the psychooncology service. Possible key factors influencing the effectiveness of service interventions were also investigated. The results showed that participants who had access to the psycho-oncology service showed significant improvements in all outcome measures by the end of therapy. The majority of these were maintained 3 months later. Improvements were also observed in the control group. Reasons for accessing therapy centred on diagnosis/prognosis concerns, communication with family, and talking to a non-family member about their worries. Although clients had no specific expectations prior to therapy, previous psychotherapy experiences influenced their perceptions of its potential effectiveness. Therapists’ personal and professional qualities were also viewed as crucial. Five key themes were identified as most beneficial - receiving individualised support, talking to someone who was not family, receiving expert/professional support, regaining a sense of control, and service availability/flexibility. Overall, psycho-oncology interventions had a significantly positive impact on clients’ lives, and were viewed as being extremely beneficial for those experiencing cancer-related distress. This research provides a unique contribution to the limited psycho-oncology research in New Zealand