Description
The Simonton Method focuses on interactions between the mind and the body and how the mind can affect health, the course of disease, and overall wellbeing. The Simonton Method of counselling for cancer patients is based on a combination of mind-body modalities: cognitive-behavioural (based on belief work: approach of Rational Emotive Behavior Therapy), relaxation exercises, guided imagery and mindfulness-based meditation practice. According to its advocates, the Simonton Method is aimed at prolonging survival time and improving quality of life of cancer patients.
Efficacy
No controlled clinical trials are available. Results from one uncontrolled trial (n=245) with methodological shortcomings do not allow any conclusions about survival times or quality of life.
Safety
No data on safety of this method as a combination of mind-body modalities can be found. The different modalities have a good safety record, when used separately.
Citation
Mora D, Wider B, CAM Cancer Collaboration. Simonton Method [online document], Aug 31, 2023
Document history
Assessed as up to date in August 2023 by Dana Mora. Revised and updated in August 2021 by Barbara Wider. Assessed as up to date in August 2020, January 2019, February 2017, January 2015 by Barbara Wider. Summary first published in September 2012, authored by Lieve Vanschoubroek and Michaela Sieh. Next update due: August 2026
Description
The Simonton Method focuses on interactions between the mind and the body—how beliefs, attitudes, lifestyle choices, spiritual and psychological perspectives impact physiology and immune function, and how they can affect health, the course of disease, and overall wellbeing (SCC 2023). The Simonton Method of counselling is therefore based on a combination of mind-body modalities: cognitive-behavioural (based on belief work: approach of Rational Emotive Behavior Therapy), relaxation exercises, guided imagery and mindfulness-based meditation practice.
Background and prevalence
This form of counselling for cancer patients was inaugurated by the American radiation oncologist Oscar Carl Simonton (1942-2009) and his wife Stephanie Matthews-Simonton in 1973. They belonged to the pioneers of the psychosocial oncology movement that started to develop in the 1970’s. Dr. Simonton created the first cancer counselling program to recognize the role and importance of family and personal support and to include them in the treatment plan. It evolved from the concept that beliefs, feelings, attitudes and lifestyle are important factors affecting health.
The Simonton Cancer Center is located in California, USA but the method is used internationally with group workshops, also called “patient week/program”, based on the Simonton Method being offered in Germany, the Netherlands, Italy and Japan. (SCC 2023)
Alleged indications
As an adjunctive technique, the Simonton Method is founded on the holistic belief that the body, mind and emotions are inseparable and function as a system. A change in one part of the system could result in change throughout the system [Klisch 1980].
Elements of Rational Emotive Behavior Therapy are promoted to help the patient to change beliefs and thus may lead to regaining health. In guided imagery exercises according to the Simonton Method, cancer patients imagine their bodies fighting cancer cells and winning the Battle.
Mechanism of action
The founder of the Simonton Method concluded his pilot study and his experience with cancer patients that this method can significantly prolong survival time [Simonton 1980; Simonton 1981]. Self-healing capacities are seen as a very important factor in the recovery process. The method intends to empower patients by improving these self-healing capacities. Enhancement of quality of life is one of the primary goals of this method.
The mechanisms of action are to be seen in the rather non-specific effects of mind-body modalities. Changing inner belief systems may lead to a change in emotional reactions to stressful life events. This process helps the patient to reduce chronic stress factors. Quality of life and the general state of health could thus be improved. Relaxation, guided imagery and mindfulness-based meditation techniques may also induce stress reduction and improvement of quality of life.
Application and providers
The Simonton Method of counselling is offered through the "Getting Well Again" Program, a five-day retreat based on Dr. Simonton's model for emotional and stress intervention, patient education, and support. The general concept of the Simonton Method can also be implemented in individual sessions.
There are many cancer patients who learn about the modality by reading Simonton’s books or by listening to tapes with lectures and guided imagery sessions. Two books are available for patients and their support persons: “Getting Well Again” and “The Healing Journey” by Dr. Simonton [Simonton 1992a; Simonton 1992b]. Dr. Simonton is also the creator of the film “Affirmations for getting well” (Touchstar Productions, 1997).
It cannot be estimated how many patients use elements of the program as part of self-help management without following a structured patient week or individual counselling. Visualization (sometimes “according to the principles of Simonton therapy”) is used in many psychosocial support programs, without adhering to the original concept.
The Simonton Cancer Center issues three levels of certificates for professional counsellors. (SCC 2023) It is the only institution that has been authorized by the late founder of the Simonton Method to issue training certificates. (SCC 2023) Therapists who are certified by SCC need to be members of professional associations in their home country and also need to agree to ethical guidelines. The Simonton Center publishes an list of international accredited therapists on its website.
The American Cancer Society evaluated the Simonton Method in 1981 (Anon 1982). It concluded that “The consensus of the consultants at Memorial Sloan-Kettering Cancer Center and at Mt. Sinai Medical Center, who are psychiatrists and psychologists, was that although in its more positive aspects the Simonton technique may increase patient comfort and ability to deal with cancer, there is no scientific evidence that psychological and psychosomatic factors will alter the course of the disease.” The Society's Committee on Unproven Methods of Cancer Management also suggested that the methods advocated and employed by the Simontons were subject to controlled scientific studies. (Anon 1982)
From 1974 to 1978 Dr Simonton conducted one uncontrolled trial (see below) of 245 cancer patients in order to assess the modality he inaugurated. This is the only clinical trial concerning the Simonton Method. Preliminary results were published in one paper and a conference abstract [Simonton 1980; Simonton 1981]. The study itself and the two publications are of low methodological quality. There are still no rigorous controlled clinical trials available. Further research on the assessment of the Simonton Method in the now implemented version is also needed.
Antitumour treatment
Included studies
Overall 245 patients were enrolled in the uncontrolled trial and received 5 to 10 days of group and individual counselling. The intervention techniques mentioned were relaxation, guided imagery, imagery drawings, evaluating and changing inner beliefs (belief work), a program of physical exercise, education regarding diet. The first publication evaluated 75 patients (belonging to 3 patient groups: breast, lung and colon cancer) (Simonton 1980). The following year a conference abstract was published reporting results for 123 patients (Simonton 1981).
The outcome stated was “median survival time”, whereas quality of life and quality of death were also assessed. Survival time of the intervention group (grouped according to cancer site) was compared to a parameter called “median national survival time”, which was based on several publications. For breast cancer, the intervention group showed a median survival of 35 months, compared to 16 months “median national survival time”. For bowel cancer, the median survival of the intervention group patients was 21 months versus 11 months. For lung cancer, results were presented from 14 months for intervention group and 6 months for the “median national survival time”. The author concluded that survival was prolonged and quality of life was improved. The conference abstract reports median survival times of 38.5 months in breast cancer patients, 22.5 in colon cancer patients and 14.5 in lung cancer patients which is assessed as “considerably longer than the median nation survival” by the authors.
There are several elements that may have affected the outcomes of the trial. The validity of the comparison data has been questioned. There was no control group; although a planned matched-pair trial was announced, this has to date not been published. The patient population was highly selected, motivated, well-educated, self-referred. Disease stages and grades are not mentioned as variables concerning the assessment of overall survival. Breast cancer patients received different conventional treatments during the trial period: differing from high-dose multiple-drug chemotherapy to radiotherapy and hormonal therapy. Differences in conventional treatment need to be taken into account as confounders. Regular individual psychotherapy sessions before and after the intensive patient week were obligatory for all patients enrolled in the trial. Therefore, it is not possible to distinguish what the specific effects of the Simonton Method were and what effects the individual psychotherapy sessions may have had. Dr. Simonton concluded that the results presented could not be generalized.
No data on adverse effects, contraindications and safety of the Simonton Method as a combination of mind-body modalities can be found. Concerning the different elements of the Simonton Method (cognitive-behavioural therapy, relaxation, guided imagery, mindfulness-based meditation), it can be said that each of them used separately has a good safety record as part of supportive cancer care.
Adverse events
None known.
Interactions
None known.
Contraindications
Mental illness could potentially be a contraindication.
Warnings
Dr. Simonton pointed to the possible risks of counselling practices that do not take into account the patient’s existing coping mechanisms. He did not elaborate on what the detrimental effects of the counselling program had been on some of the patients enrolled in the trial.
Anon (1982). Unproven methods of cancer management: O. Carl Simonton, M.D. CA Cancer J Clin; 32(1):58-61.
Kaspar C (2015). Die Simonton Methode: Selbstheilungskräfte stärken, Krebs überwinden. Reinbek: Rowohlt.
Klisch ML (1980). The Simonton Method of visualisation: nursing implications and a patient's perspective. Cancer Nursing 3:295-300.
SCC, Simonton Cancer Center website (2023): www.simontoncenter.com, accessed 29th August 2023.
SCE, Simonton Center Europe website (2023): https://simonton.eu, accessed 29th August 20223.
Simonton OC, Matthews-Simonton S, Sparks TF (1980). Psychological intervention in the treatment of cancer. Psychosomatics 21:226-233, 1980.
Simonton OC, Matthews-Simonton S, Creighton JL (1992a). Getting Well Again - A Step-by-Step, Self-Help-Guide to Overcoming Cancer for Patients and Their Families. New York: Bantam Doubleday Dell Publishing.
Simonton OC, Hampton B, Henson R (1992b). The Healing Journey. Lincoln, NE: Authors Choice Press.
