The Effect of Cognitive Behavior Stress Management Program on the Distress, Coping Skills, and the Social Support of Omani Women with Breast Cancer: A Pilot Study

Abstract

Cognitive behavior stress management (CBSM) is an effective intervention that is suitable for use with women who have been diagnosed with breast cancer;  however, the effectiveness of CBSM in an applied clinical setting has not been examined in an Omani cultural context. Therefore, we examined the effectiveness of an 8-week CBSM group program using a sample of 6 Omani women who had been diagnosed with early-stage breast cancer. The purpose of this case study was to examine clinically significant changes in distress, social support, and the psychological ability to cope with breast cancer from pretest to posttest and follow-up (i.e., 1 month later). Overall, the group yielded strong positive effect sizes indicating clinical improvement over time in distress symptoms and social support, but strong unfavorable effect sizes in cognitive avoidance.  All women met the measurement criteria for anxiety and depression at baseline. The 2 participants who had the highest levels of baseline distress demonstrated the most pronounced improvements in depression and anxiety at posttest; however, their scores had returned to baseline levels at follow-up. On the other hand, the qualitative feedback of all 6 women underscored the effectiveness of the program in facilitating cognitive restructuring, relaxation, and social support. The present findings offer preliminary support to the effectiveness of CBSM in reducing psychological distress, improving coping skills, and fostering social support skills among Omani women with breast cancer. However, the program also had a few unfavorable results with regard to one coping strategy, namely, cognitive avoidance. Nevertheless, the findings suggest that social support can alleviate distress and improve coping skills among Omani women who struggle with breast cancer and its treatment. Further, strategies that can address cognitive avoidance and temporally sustain the positive effects of CBSM must be examined in future studies. This sentence sounds rather incomplete because it is missing a dependent variable (e.g., effective in reducing/improving  . . . ). Therefore, please consider including this information for better clarity. As with the previous sentence, this one sounds slightly incomplete because the dependent variables have not been listed. Therefore, please consider doing so to enhance clarity. I have removed this word because you used both quantitative and qualitative techniques. The meaning of this sentence is unclear. However, I have edited it as follows (see below) based on contextual information. Please use it if it is consistent with your intended meaning. “Overall, the program alleviated distress symptoms, and the corresponding effect sizes were large. However, the program also lead to an undesirable increase in cognitive avoidance; the effect size for this trend was also large.” The use of the term “rebounded” is inappropriate in this instance. Therefore, I have made the necessary change here and in all instances in this document.