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Validation of CALM psychosocial therapy in metastatic breast cancer patients in Portugal

Information and support gap


According to the Champalimaud Foundation, the prevalence of severe distress in metastatic breast cancer (MBC) patients is reported to be 38-47%, making it critical for these patients to benefit from psychosocial cancer services. In Portugal systematic screening for distress and psychosocial needs of cancer patients is not mandatory despite the recognition that high levels of distress negatively impact patients’ quality of life and their clinical outcomes. Also there are no available short cost-effective psychotherapeutic interventions to address psychosocial needs validated for MBC Portuguese patients. To address these issues, the Champalimaud Foundation will test and validate a therapy intervention based on the CALM (Managing Cancer and Living Meaningfully) intervention developed and tested in Canadian and proved to reduce significantly depression in the advanced cancer population.

Founded in 2004, the Champalimaud Foundation is a private, non-profit organisation dedicated to making advances in biomedical science. The Champalimaud Clinical Centre (CCC) is an advanced centre for science, medicine and technology, comprising a clinical facility for both research and treatment of disease. The core mission of the CCC is to offer premier clinical services, including early diagnosis, treatment, counselling and follow-up, as it strives to define new standards of patient care.

Quote Luzia Travado

“With this grant we expect to make available for Portuguese speaking MBC patients a cost-effective psychosocial intervention to respond to patients’ psychosocial needs and contribute to reducing their high levels of distress and existential suffering in this most challenging phase of their lives.”

Luzia Travado, Head of Psycho-Oncology

Project description

In 2017 the Champalimaud Foundation was awarded a SPARC MBC Challenge grant, to test and validate the CALM model in Portugal.

CALM is a promising, new individual brief psychotherapy intervention designed for patients with advanced cancer. It is a semi-structured intervention of 3-6 therapy sessions each with a duration between 45-60 minutes. The CALM sessions address four broad and interrelated domains found to be relevant in this population, which are: 1) symptom management and communication with healthcare providers ; 2) changes in self and relations with close others; 3) sense of meaning and purpose ; and 4) the future and mortality. The intervention was proven to be successful in Canada and other European countries, showing significant reductions in depressive symptoms and death anxiety for breast cancer patients as well as a significant improvement in spiritual wellbeing over time.

The Champalimaud Foundation plans to conduct a validation of the CALM therapy model for the Portuguese MBC population, delivered in the context of the multidisciplinary treatment and care of patients at the Champalimaud Breast Unit. They will recruit 30 patients with MBC, which will be explained the therapy to them and in case of acceptance they will be asked to complete an informed consent form. This study was approved by the ethics committee.

Moreover, the Champalimaud Foundation expects to translate, adapt and validate the CALM Manual and Clinical assessment tools and to create a ready-to-use package which they will disseminate to their community of healthcare providers.


The Champalimaud Foundation hope that this project help alleviate depression and death anxiety as well as increase the sense of meaning and purpose in life in patients diagnosed with MBC in Portugal. They also anticipate that the CALM therapy package may be adopted and used in other centres and hospitals throughout the country and in other countries for the benefit of Portuguese-speaking MBC patients.


Organisation's website: The Champalimaud Foundation

(Information from the project description and context is compiled from the SPARC reports)

Last update: 
Tuesday 17 March 2020
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