A Content Analysis of the Counseling Sessions of Dyads with Breast and Prostate Cancer: Linguistic Predictors of Psychosocial Adjustment and Thematic Analysis of Key Concerns

Abstract

The purpose of this investigation was to explore how participants' language use during counseling (overall emotional expression, positive emotional expression, and communal coping, or "we-talk") was associated with superior adjustment, as measured by four psychosocial outcome variables (depression, positive affect, negative affect, and relationship satisfaction); as well as to identify the key concerns of dyads with cancer, how concerns differed by role and sex, and if they were associated with participants' well-being. The present study was a content analysis of the counseling sessions of 43 dyads (N = 86) with breast and prostate cancer. Using a multi-method approach, the audio recordings of 228 counseling sessions were transcribed and analyzed linguistically (quantitatively) and thematically (qualitatively).Results of the linguistic analyses revealed that participant's use of "we-talk" had the most consistent and beneficial effect on outcomes; specifically improved depression, negative affect, and relationship satisfaction. These findings suggest that it might not be as important how much a person expresses themselves emotionally, but rather, whether they have a close relational partner that they see as an instrumental part of their coping process and significantly intertwined in their life, which is reflected in their language use of communal coping.Results of the thematic analyses revealed that survivors' concerns were more focused on cancer and treatment related issues, whereas partners' concerns centered on the well-being of their spouse/partner with cancer, and what they were doing to help their loved one cope with his/her illness. The overarching key concern that was intertwined in participants' discourse was frequent discussion of relationship maintenance, negotiation, and communication issues. In addition, discussion of these concerns showed greatest benefits for women with breast cancer.The findings of this study has implications for counselors and clinicians in that language use and topics discussed during counseling have the potential to increase psychosocial adjustment for dyads coping with cancer. The general discourse of survivors mirrored that of their partners, which indicates that helping to modify or change how one person speaks, has the potential to influence how their partner talks as well; which has implications for the well-being of both dyad members.