Dance/movement therapy (DMT) for cancer survivors and caregivers in Fairbanks, Alaska

Abstract

Worldwide, the burden of cancer continues to grow and impact the quality of life of patients, their families, and caregivers. Aside from the physical effects and financial costs of cancer and its treatment, a significant portion of cancer patients and their caregivers experience emotional, social, and psychological distress throughout the trajectory of their illness and extending to long-term survivorship. Despite medical advances in cancer treatment, a cancer diagnosis is still often considered to be synonymous with death, pain, and suffering. It has been established that engaging in the creative arts could promote quality of life (QOL) especially for those suffering from chronic illnesses such as cancer. Specifically, studies on dance/movement therapy (DMT) have indicated its efficacy as a complementary and holistic intervention in providing social support, decreasing fatigue and stress, increasing mobility, and enhancing overall wellbeing of cancer survivors. Results from a pilot DMT study that explored the cultural suitability, feasibility, and benefits of using DMT in the post-treatment QOL of Alaska Native cancer survivors indicated positive impacts on participants' mobility, body awareness, emotional expression, self-care, and wellbeing. Participants from the pilot study highlighted the need for providing DMT in the community and opening the DMT group to both cancer survivors and caregivers. This suggestion was in consideration of the lack of support groups available to both cancer survivors and caregivers that focus on cancer survivorship and promotion of quality of life. Existing locally available cancer support groups emphasize cancer education but are limited in meeting the psycho-social, emotional and physical needs of both cancer survivors and caregivers. The encouraging results and feedback from participants not only supported existing studies on DMT's cross-cultural benefits in promoting QOL among cancer survivors but also provided the rationale for a larger dissertation study for survivors and caregivers in Fairbanks, Alaska. It was in this context that DMT's significance in increased survivorship and QOL among cancer survivors and caregivers in Alaska was examined. The study employed a sequential, mixed methods small-N design in investigating the therapeutic benefits of DMT among cancer survivors and caregivers (N = 16) in a practice-based setting in Fairbanks, Alaska. Adhering to the principles of community-based partnership research (CBPR), the study established a collaborative partnership with the Fairbanks Memorial Hospital as it piloted a 12- week, open DMT group intervention for cancer survivors and caregivers. The study was conducted in two phases: Phase 1: DMT Intervention (12 weeks) and Phase 2: Follow-up and Findings Meeting (3 months after the last offered DMT session), which assessed DMT’s lasting effects on participants. Quantitative and qualitative data were employed to examine DMT’s effects on participant’s mental health functioning, body awareness, subjective QOL, and sense of group cohesiveness and engagement with the DMT group. Quantitative findings indicated significant improvements in participants’ mental health functioning with a moderate effect size after participation in the DMT program. Although no significant pre- to post-change was found on participants’ subjective QOL, cancer survivors reported significantly better QOL (social, emotional and functional wellbeing) at the three-month follow-up, suggesting that DMT can offer late, but possibly lasting, positive changes. Additionally, participants’ ability for selfregulation and use of avoidance as a coping tool for pain were found to increase after their DMT participation. No significant changes were noted in participants’ level of cohesion with the DMT group. However, qualitative findings indicate that participants found that the DMT program was extremely beneficial in promoting their physical, psychological, social and spiritual wellbeing and expressed overall strong positive feelings toward their DMT group. Implications for research and clinic practice were discussed as informed by the study’s strengths and limitations. One the study’s strengths is its adherence to the principles of community-based participatory research (CBPR) as an over-arching framework in guiding all aspects of the research process. By establishing a collaborative partnership between the UAF academic community and the local community hospital (Fairbanks Memorial Hospital), this study was able to build on the community’s strengths and resources in an effort to help promote cancer survivorship for cancer survivors and caregivers. Future recommendations include further strengthening collaborative community partnerships with a larger, DMT confirmatory study using a Randomized Control Trial (RCT) design, while integrating a mixed-methods approach. Implementing these strategies would help establish DMT’s efficacy as a holistic and ecologically valid intervention for cancer survivors and caregivers in Fairbanks, Alaska.