The efficacy of Life Review Therapy combined with Memory Specificity Training (LRT-MST) targeting cancer patients in palliative care: A randomized controlled trial

PLoS One. 2018 May 15;13(5):e0197277. doi: 10.1371/journal.pone.0197277. eCollection 2018.


Background: The aim of this study was to evaluate the efficacy of an intervention combining Life Review Therapy (LRT) and Memory Specificity Training (MST) (LRT-MST) to improve ego-integrity and despair among cancer patients in palliative care.

Methods: In this multicentre randomized controlled trial, cancer patients in palliative care were randomized to the intervention group (LRT-MST; n = 55) or waiting-list control group (n = 52). LRT-MST is a 4-session home-based psychological intervention that aims to retrieve specific positive memories, to re-evaluate life events and to reconstruct the story of a patient's life, including the diagnosis of incurable cancer. Outcome measures were ego-integrity and despair (NEIS), psychological distress, anxiety and depression (HADS), quality of life (EORTC QLQ-C15-PAL), and specificity of the autobiographical memory (AMT). NEIS, HADS and EORTC QLQ-C15-PAL were assessed at baseline (T0), 1 month later (post-treatment; T1), and at 1 month follow-up (T2). AMT was assessed at T0 and T1. Linear mixed models (intention to treat) were used to assess group differences in changes over time. Independent samples t-tests were used to assess group differences at T0, T1, and T2, and effect sizes (ES) were calculated at T1 and T2.

Results: The course of ego-integrity (not despair) improved significantly over time (p = .007) in the intervention group compared to the waiting-list control group, with moderate, but insignificant, effect sizes at T1 (ES = .42) and T2 (ES = .48). Compliance rate was 69% and total dropout rate was 28%, both primarily related to disease progression and death.

Conclusions: LRT-MST seems effective among cancer patients in palliative care to improve the course of ego-integrity.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / therapy
  • Depression / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Male
  • Memory, Episodic
  • Middle Aged
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Palliative Care*
  • Psychotherapy / methods*
  • Quality of Life
  • Stress, Psychological / therapy
  • Treatment Outcome

Associated data

  • figshare/10.6084/m9.figshare.5632201

Grant support

This work was supported by ZonMw (, The Netherlands Organisation for Health Research and Development [grant number: 11510003]. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.