- The Simonton method is a combination of mind-body modalities.
- Proponents say that it can prolong survival and improve quality of life.
- No conclusions on effectiveness can be drawn because of lack of clinical studies.
- No data on safety of the modality-combination can be found. Used separately, the modalities are generally safe and well tolerated.
The Simonton method of counselling for cancer patients is a combination of mind-body modalities: cognitive-behavioural elements, relaxation exercises, guided imagery and meditation. According to proponents, the Simonton method aims at prolonging survival time and improving quality of life. No conclusions concerning effectiveness and efficacy can be drawn because of the lack of high quality clinical trials. 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.
Assessed as up to date in January 2019 by Barbara Wider.
Assessed as up to date in February 2017 by Barbara Wider.
Assessed as up to date in January 2015 by Barbara Wider.
Summary first published in September 2012, authored by Lieve Vanschoubroek and Michaela Sieh.
Lieve Vanschoubroek, Michaela Sieh , CAM-Cancer Consortium. Simonton Method [online document], http://cam-cancer.org/en/simonton-method. February 8, 2017.
The Simonton method of counselling 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. The Simonton method is built on the idea that beliefs, inner attitudes, emotions and lifestyle have an impact on recovery from physical illness. 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 system1. 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.
Application and dosage
Counselling is offered during 5 day intensive group workshops, for cancer patients and their support person. The general concept of the Simonton method can also be implemented in individual sessions.
History / providers
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. From 1974 until 1978, a pilot study on his counselling method was performed by Dr. Simonton himself2,3.
The Simonton method is used worldwide with centres in the United States (the Simonton Cancer Center in California), the Netherlands, Germany, Italy, Poland, Japan and South Africa.
Claims of efficacy / Mechanisms of action / Alleged indications
The founder of the Simonton method concluded from the performed pilot study and from his experience with cancer patients that this method can significantly prolong survival time2,3. 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.
Prevalence of use
Group workshops, also called “patient week/program”, based on the Simonton method are offered in many countries including North America, Germany, the Netherlands, Italy, Poland, Japan and South Africa. They are attended by approximately between 100 and 200 patients per year worldwide. Individual counselling is offered by 30 therapists throughout Europe. 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 sessions4,5. 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 (SCC) issues three levels of certificates for professional counsellors: Counseling Therapist SCC, Supervising Therapist SCC, Teaching Therapist SCC. The Simonton Cancer Center is the only institution that has been authorized by the late founder of the Simonton method to issue training certificates. 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.
Fees for a 5-day patient program range from € 700 to € 1970 (depending on the country where the program takes place), accommodation and meals are not included. The support person is included in the fee. Individual counselling costs approximately € 60/ hour. Group sessions cost about €12 per person/ hour.
Dr. Simonton conducted one uncontrolled trial (see below) in order to assess the modality he inaugurated. This is the only clinical trial concerning the Simonton method. Preliminary results were published in two papers. The study itself and the two publications are of low methodological quality2,3. Overall, no conclusions can be drawn on effectiveness and efficacy of the Simonton method because of the lack of rigorous clinical trials. Further research on the assessment of the Simonton method in the now implemented version is needed.
From 1974 until 1978, 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)2. The second paper evaluated outcome measures of 123 patients3. The reason for this difference in numbers of included patients is not given. Both papers only mention the outcome “median survival time”, whereas it is stated that quality of life and quality of death had also been outcome parameters. Survival time of the intervention group (grouped according to cancer site) is compared to a parameter called “median national survival time”, based on several publications. For breast cancer, the intervention group showed a median survival of 35 months, compared to 16 months. For bowel cancer, the median survival of the intervention group patients was 21 months, in the control 11 months. For lung cancer, results were presented from 14 months for intervention group and 6 months for the comparison group. The correctness of the comparison data has been questioned. The author concluded that survival was prolonged and quality of life was improved.
There are several elements that may have affected the outcomes of the trial. The patient population was highly selected, motivated, well-educated, self-referred. There was no control group. A planned matched-pair trial was announced, but has not been published. Disease stages and grades are not mentioned as variables concerning the assessment of overall survival. One paper mentions the different conventional treatments that breast cancer patients received 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 further scientific studies or publications in peer-reviewed journals concerning the Simonton method have been performed.
Two books were published, written for patients and their support persons: “Getting Well Again” and “The Healing Journey” by Dr. Simonton4,5. Dr. Simonton is also the creator of the film “Affirmations for getting well”.
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.
In general, people with a condition of a psychological dysfunctional nature could be potentially disqualified from receiving standard counselling for cancer.
The Simonton method is sometimes recommended as an alternative to conventional cancer care.
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.
- Mary Lou Klisch, R.N., M.S.N., The Simonton Method of visualisation: nursing implications and a patient's perspective. Cancer Nursing 3:295-300, 1980.
- Simonton OC, Matthews-Simonton S, Sparks TF. Psychological intervention in the treatment of cancer. Psychosomatics 21:226-233, 1980.
- Simonton OC, Matthews-Simonton S. Cancer and stress: counselling the cancer patient. Med J Aust 1: 679, 682-683, 1980.
- Simonton OC, Matthews-Simonton S, Creighton JL. Getting Well Again - A Step-by-Step, Self-Help-Guide to Overcoming Cancer for Patients and Their Families. Bantam Doubleday Dell Publishing; 1992.
- Simonton OC, Hampton B, Henson R. The Healing Journey. Authors Choice Press; 1992.