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The program provides Neuro Emotional Technique (NET) to patients with traumatic stress associated with cancer. NET is an innovative technique that combines ancient Chinese medicine (CM) with principles of cognitive therapy. While stimulating meridians (using pressure points) the patient identifies cognitions: the nature of thoughts and internal dialogue associated with the trauma combined with the emotions that recollecting the traumatic event elicit. There is a desensitization phase (patient stimulates acupressure points and does simple breathing exercises). There is no other treatment that combines CM into psychotherapy, most offer it as a separate service. fMRI data show brain regions involved with traumatic memories/ distress had markedly reduced activity after NET and were associated with clinical improvement of symptoms associated with distressing recollections and these changes were associated with improvement of traumatic stress symptoms. After NET, reactivity in parahippocampus, brainstem, anterior cingulate, and insula were significantly decreased. NET produced significant reductions (p<0.05) in distress on BSI-18, anxiety on the STAI, and traumatic stress on IES and PTCI. NET reduces emotional distress in patients who suffer from traumatic stress associated with cancer. This funding would allow more cancer patients to receive treatment and for treatment to be manualized for other doctors to use.
One-third of cancer survivors suffer from traumatic stress: “distressing recollections of cancer-related experiences”. Common distressing memories include moment of diagnosis or some painful aspect of cancer care. Two key psychological symptoms include, 1) avoidance (e.g. not scheduling follow-up visits or tests because they are reminders, conscious or non-conscious, of the distressing event), and 2) intrusive thoughts (aspects of the event that pierce consciousness at unwanted times). There are no specific treatments designed to help the cancer community cope with the functional impairment and neurological changes that can result from the diagnosis. Our program demonstrates NET significantly improves functioning for this population. It is the only program that has these detailed brain scans to demonstrate success which is important because avoiding follow-up care can be life-threatening and it is the only program that combines CM with therapy making it truly a mind-body technique unlike any other.
We are aware of no other programs to date that have assessed the use of psychosocial interventions in cancer survivors who experience cancer-related distressing recollections. The purpose of our program was to provide neuroimaging data of the physiological effects of the NET intervention that correspond with reduction of traumatic stress symptoms, in cancer survivors with distressing cancer-related memories. Since we have demonstrated that NET is significantly effective there is now a need for the steps of this treatment to be clearly defined and made available to practitioners. The award would allow for more cancer patients to be treated and that data would be integrated into a comprehensive treatment manual. This manual would include detailed scripts from the treatment sessions that would increase consistency of the treatment application across providers. Other treatment centers could then offer NET to patients with more likelihood of achieving the same significant results.
Thomas Jefferson University supported the first portion of the NET program through the Jefferson Myrna Brind Center for Integrative Medicine (JMBCIM). We had access to fMRI equipment as well as data collection support. JMBCIM is closely connected with the Sydney Kimmel Cancer Center at TJU and so program participants were referred by a physician or social worker. They have a commitment to supporting this program and continue to identify cancer survivors. JMBCIM has grants and clinical revenue that ensure the sustainability of the NET program. We have also partnered with the Marcus Foundation because of their commitment to integrative medicine. The ONE foundation is committed to supporting research that documents the effectiveness of NET so this grant will not be used for that purpose. Instead it will be used so that the information from the efficacy studies will be clinically meaningful– other practitioners can replicate the same treatment and results.
This award would allow other hospitals to duplicate the NET program which is a short-term treatment (3-5 session of 45 minutes). The money would allow additional patients to receive treatment for free with the understanding that the session content would create a therapy manual. That manual would provide step-by-step instructions on how to utilize NET to make meaningful neurological changes post cancer. The manual will benefit from case examples and therapeutic transcripts so that practitioners can become adept at the specific language and questioning that facilitates change. The current data demonstrates that a brief NET reduces reactivity in a number of brain structures associated with the perception of emotional traumas. By reducing the brain’s reactivity to traumatic memories, NET diminishes distress and improves self-regulation. It is essential that this data not be stored away in a journal but be put into a manual so others can access the treatment.
NET was evaluated using fMRI and clinical data. The results suggest NET alters reactivity in many brain structures such as parahippocampus, anterior cingulate, and insula. Decreased reactivity with NET supports the notion that NET helps to “normalize” brain function in response to exposure to the traumatic stimuli. In terms of clinical results, those who received NET compared to the waitlist control group had significant improvements in BSI scores for somatization, depression, anxiety, and global severity, as well as significant improvements in state/trait anxiety scores. In addition, there were significant improvements in the IES and PTCI scores with NET suggesting trauma specific improvements. And given the clinical response in the NET group, these physiological changes underlie the reduced clinical reactivity experienced by the patients. This means that after receiving the NET intervention, areas that previously responded strongly to the traumatic stimulus were no longer as reactive and patients felt better.