Table 3.

Descriptive table of interventions focused on the patient-life partner dyad faced with advanced cancer.

References	Disease	Intervention	Population	Instruments	Data analyses	Significant results	Non-significant results
Mohr et al. (2003)	Metastatic cancer	8 sessions of 50/60 min. 1/week. Reduction of distress in the couple, improving communication, and increasing intimacy to the degree that these are goals of the couple. Facilitate change of meaning (beliefs, goals, values). Increase intimacy, emotional support, reciprocity. Facilitate discussion of death and dying. Facilitate discussion about children.	6 couples Patients: -women 66.7% -age 49.3 y Caregivers: -women 33.3% -age 50.1 y	Death anxiety and worrying Depression: Beck Depression Inventory-II (BDI-II) Quality of life: global QOL Relationship quality: Positive relationship and negative relationship Social support: Perceived Spousal Support Scale (positive support and negative support). Caregiver burden: Zarit Caregiver Burden	Effect sizes	Patients: Decreased distress about dying Improved positive relationship Partners: Decreased frequency of worry about dying	Patients: Worry about dying Depression Quality of life Relationship Negative Positive support Negative support Partners: Distress about dying Depression Quality of life Caregiver Burden Relationship positive Relationship Negative Positive support Negative support
McWilliams (2004)	Terminal breast cancer	Psychotherapy based in attachment theory aimed at increasing intimacy	1 couple: 1 female patient aged 83 y, male caregiver aged 81 y	Case study		Psychological growth and preparation for future bereavement. To trust each other more and to trust that they could continue to grow as a couple even though their time was limited.
Mowll et al. (2015)	Advanced cancer	PDI–CI intervention (to improve communication around end-of-life issues for couples where one has advanced cancer) 1 session of 1 h.	9 couples: Patients: -women 55% -age 64 y Caregivers: -women 44.4% -age 64 y	Semi-structured interviews	Thematic analysis	The intervention allowed the men to speak. Men and women in couples expressed that the structure of the PDI-CI is particularly useful for men to discuss issues. The intervention helped lift the veil on the feelings of each other. A number of couples reported that the intervention highlighted areas of difference between them, which then made it easier to clarify communication at that time or afterwards. The intervention facilitated changes in behavior toward others. A couple said that discussing the PDI-CI questions made the patient recognize her deteriorating health and accept more help from her husband. A patient from another couple noticed changes in the way her husband looked after her. The importance of the intervention to help prepare for the end of life was also emphasized. The intervention validated an already functional mode of communication. A number of couples felt that the intervention improved their already good communications, which aroused positive feelings. Through the intervention, more than half of the participating couples expressed that they could return to see the psychologist.
Benzein and Saveman (2008)	Multisite cancer	Conversations about hope and suffering 3 sessions every 2 weeks	6 couples Patients: -women 83.3% -age 52–84 years	Semi-structured interviews	Thematic analysis	Couples feel that they were part of a trustful relationship, and that it was a healing experience. Opportunity to unburden themselves. Way of learning and finding new strategies for managing daily life.
Lantz and Ahern (1998)	Advanced cancer	Existential psychotherapy (re-collection)		Case study		To reduce the meaninglessness and the symptoms and problems around meaningless that often develop around the time of the death of a family member. To help the couple facing death to remember, find, discover, confirm, and honor meanings that have been reaffirmed and deposited in the eternity of the past.
Wagner et al. (2016)	Various forms of cancer	Existential psychotherapy: to increase meaning in life and sense of transcendence, determine wishes and hopes, and help patients and their partners communicate more openly about death and dying. 4 sessions of 60 min.	12 couples Patients: -women 63.4% -age 59.1 y Caregivers: -women 54.4% -age 59.6 y	Anxiety and Depression: the Hospital Anxiety and Depression Scale (HADS) Meaning: Meaning/Peace subscale of the Functional Assessment of Chronic Illness Therapy Spiritual Well-Being scale (FACIT-Sp) Appraisals: Cognitive Appraisals of Health scale (CAHS) Transcendence: The Missoula Vitas Quality of Life Index (M-VITAS) Interview (assess satisfaction of intervention)	Descriptive statistics and paired samples t-tests. Thematic analysis.	Partners: Decreased anxiety and depression Secondary Appraisals;Increased peace with Illness Patients: Decreased threat appraisals	Partners: Meaning/Peace Threat appraisals Harm/Loss Appraisals Challenge Appraisals Patients: Anxiety and depression Meaning/Peace Harm/Loss Appraisals Challenge Appraisals Secondary Appraisals Peace with Illness Transcendence
Reny (2020b)		Support		Case study		Allows ”emotional discharge.“ Means of recirculating the word within the couple. Allows (through the support and mediation offered) that the privacy of the subject and the couple is heard and recognized in the face of the invasion of hospital and caregivers within the couple. Opportunity to mourn the couple before the illness. A new arrangement is necessary, a new way of being together is being worked on. Preventively: promotes transmission and support for future bereavement for the loved one.
McLean and Nissim (2007)	Metastatic ovarian cancer	Emotionally focused couple therapy (modified for the advanced cancer population). To facilitate marital relationships by changing habitual and distressing patterns of interaction, to increase mutual understanding and emotional engagement, and to strengthen the marital bond. 8 sessions.	Patient: -women:100% -age: 60 Caregiver: -women: 0% -age:30 years	Case study		Breakthrough in their distress pattern and an internal shift in consciousness that allowed them to respond more effectively, sharing more primary feelings than secondary defensive reactions. They both experienced a new sense of control in their ability to defuse a painful cycle. More support, empathy and love evident in their interactions. Need for multidisciplinary support was more than necessary in view of the increasingly important physical symptoms over time generating intense distress
McLean et al. (2013)	Metastatic cancer	Emotionally focused couple therapy (modified for the advanced cancer population). To facilitate marital relationships by changing habitual and distressing patterns of interaction, to increase mutual understanding and emotional engagement, and to strengthen the marital bond. 8 sessions of 60 min. 1/week.	42 couples (22 Intervention Group; 20 Control Group) Patient IG: -women:29% -age:51.83 y Caregivers IG: -women: 24% -age: 48.82 y Patient CGs: -women: 26% -age: 49.45 y Caregiver CGs: -women: 21% -age:50.89	Marital functioning: Revised Dyadic Adjustment Scale Depression: Beck Depression Inventory-II (BDI-II) Hopelessness: Beck Hopelessness Scale (BHS) Empathic caregiving (patient): Relationship-Focused Coping Scale(RFCS) Caregiver burden (caregiver): Two subscales (Demand/Difficulty) of the Caregiver Burden Scale	Descriptive and inferential statistics (ANCOVAs)	Improved marital functioning Improved patient's perspective of caregiver‘s empathic behavior	Depression Hopelessness Caregiver burden time Caregiver burden difficulty
Clements-Cortes (2011)	Multisite cancer	Music therapy	2 couples Patient -women: 50% -age: 77 y Caregivers –women: 50%	Semi-structured interviews were conducted with participants and coparticipants	Thematic analysis	The results indicate that examining life, signing songs and creating musical gifts were central to each participant's process. Love was the central feeling that had to be conveyed by all participants to help them complete their relationships. Grief were part of the experiences of all participants. The sub-themes of strength/hope, denial, fear/pain, and knowledge can be linked to it. People who are going through their last weeks and days often express intense gratitude for their lives and for the people they have known. Each participant grew in their understanding of the importance of engaging in the completion of the relationship with the key people in their life. All of the participants also used their last weeks and days to live instead of waiting to die. They were open to growth, learning and the possibility of transformation. Strength / hope animates couples facing the end of life, just like courage and strength. Inherent in accepting your diagnosis of terminal cancer is the awareness to say goodbye to family and friends, and ultimately to life as the person knows it. Although it was difficult for the participants to say goodbye verbally, their actions show that they were doing just that.