A Pilot Study on the Effectiveness of a Cognitive–Existential Rehabilitation Counseling Protocol on Hope in Wives of Men with Cancer

Abstract

Background: Cancer can undermine the psychological and existential well-being of patients and their spouses. As caregivers, spouses often experience reduced hope and diminished psychological resilience. Cognitive-existential rehabilitation counseling may provide a promising framework for enhancing hope by addressing both cognitive distortions and existential concerns. Objectives: This study aimed to evaluate the effectiveness of a structured cognitive-existential rehabilitation counseling protocol in enhancing hope among the wives of men with cancer. Methods: This study employed a single-case experimental design (SCED). Five participants were recruited through purposive sampling. The intervention comprised a 12-session counseling protocol integrating cognitive and existential approaches. The Snyder Hope Scale was administered at multiple time points across the baseline, intervention, and follow-up phases. Data were analyzed using visual trend inspection, improvement rate, Percentage of Nonoverlapping Data (PND), and clinical effect sizes (Cohen’s d). Results: Recruitment was feasible in this study setting, as all eligible participants agreed to participate and completed the intervention and follow-up assessments. The findings indicated preliminary improvements in hope. Improvement rates ranged from 39.4% to 70.7%, and PND values indicated highly effective intervention outcomes across all participants, with values of 100% for the hope variable. Large effect sizes were observed across participants (Cohen’s d = 1.92 - 2.78), based on comparisons between baseline and intervention-phase scores; however, these estimates should be interpreted as preliminary indicators derived from this pilot SCED. Conclusions: The cognitive-existential rehabilitation counseling protocol was associated with clinically meaningful improvements in hope among wives of men with cancer. These findings provide preliminary support for the hypothesis that the protocol may promote psychological agency and hope among wives of men with cancer by drawing on dialectical tension between the self and the negative Other (cancer tradition), the internalization of empowering voices, and the reconfiguration of the narrative system. This protocol may represent a feasible psychosocial rehabilitation approach within mental health care in oncology settings; however, its effectiveness should be confirmed in larger controlled studies before clinical conclusions are drawn.