Effectiveness of spirituality-centered cognitive therapy and contextual transdiagnostic approach on marital mutuality, dissociative experiences, and cancer related fatigue in women after mastectomy

Introduction
Breast cancer remains the most frequently diagnosed cancer and a leading cause of cancer-related deaths in women worldwide. Post-mastectomy, women often experience heightened emotional distress, diminished quality of life, and interpersonal challenges.

Objectives
This study seeks to evaluate the comparative effectiveness of Spirituality-Centered Cognitive Therapy (SCT) and the Contextual Transdiagnostic Approach (CTA) on marital mutuality, dissociative experiences, and cancer-related fatigue in women after mastectomy.

Methods
In this randomized controlled trial, 132 women, selected based on inclusion criteria from an initial pool of 167, were randomly assigned to two intervention groups: SCT (n=66) and CTA (n=66). Each group underwent eight 60-minute therapeutic sessions over four weeks, held twice weekly from August to September 2022. Standardized questionnaires assessing marital mutuality, dissociative experiences, and cancer-related fatigue were administered pre- and post-intervention. Multivariate analysis of variance (MANOVA) with repeated measures was employed for data analysis using SPSS-24.ResultsCTA demonstrated superior effectiveness in reducing dissociative experiences compared to SCT. Conversely, reductions in cancer-related fatigue were more pronounced in the SCT group. Improvements in marital mutuality were comparable between the two therapeutic approaches.

Conclusions
Both SCT and CTA proved effective in enhancing psychological and relational well-being in women post-mastectomy. However, SCT more effectively alleviated cancer-related fatigue, while CTA showed greater efficacy in addressing dissociative experiences. These findings highlight the potential of integrating tailored therapeutic approaches to improve quality of life for breast cancer survivors.