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Dialogue House would like you to get to know some of the people who help us further the work of Dr. Ira Progoff and the Intensive Journal Method.  The current feature is Dr. Jacek Mostwin of the Johns Hopkins Medical Institutions. Dr. Mostwin is currently working on a proposed study to evaluate the effects of the Intensive Journal Method on prostate cancer patients. Click here for a summary of the study.

Dr. Jacek Mostwin of Johns Hopkins Medical Institutions

Tell us a little about yourself.  What you do at Johns Hopkins Medical Institutions?
I am currently a Professor of Urology at Johns Hopkins University School of Medicine.  Iíve been with the department for 28 years.  My expertise is in lower tract physiology including prostate cancer and incontinence.  Since 1992, Iíve been involved with providing medical support to the community of Lourdes in France.  Iíve become Director of a physicians in society course (ďPatients, Physicians, & SocietyĒ) at the School of Medicine.  I am a lifelong resident of Baltimore, except for the time when I have been away in training at medical school.

I understand you also have a D.Phil. degree.  What project did you do your dissertation on?
Well, the degree is a Doctorate of Philosophy, but it was actually a doctorate program in pharmacology.  I did my project on the urinary bladder of the guinea pig.            

Have you attended the Intensive Journal program?  What do you think of the program?
Iíve attended three retreats where I have done all three program modules each time.  I have a high regard for the programís potential and I think it fulfills many of the promises and expectations outlined by Dr. Progoff.  Through my own experience, I think that the kind of growth and self-discovery that the workshop offers actually takes place in the experience of a workshop setting.  One can use this for working out psychological issues, exploring issues creatively, and re-centering oneís own life in any stage of life.  I think itís a very flexible tool.  I do think it requires motivation on the part of the participants, but I think if you start out with any small amount of motivation, the experience will show its value and keep people coming back.

As a urologist, what are some of the non-medical issues people deal with when diagnosed with cancer face?
Depending upon the kind of cancer, there may be immediate life threatening issues or there may be transitional life experiences where there are no immediate life threatening issues. Either way, they redefine their meaning of life.  Illness in general creates a change in oneís sense of mortality and destructibility and brings on home the reality that everyone has to deal with but faces with an illness. Adjustment is a major aspect of dealing with a major illness.

Do you think the Intensive Journal program would benefit patients who are being treated for cancer?   Why?
I certainly do think the Intensive Journal program would benefit patients.  There are many aspects of life change and adaptation that are not addressed by other aspects of treatment such as surgery and radiation.  There are other support groups that one can use but they are public and involve a great deal of personal disclosure.  They do not offer the anonymity and sanctuary of the Intensive Journal workshop.  I think the journal workshop can offer the special form of supportive intervention not currently offered by any other aspects or forms of intervention.

I understand you will be a conducting a pilot  research study utilizing the Intensive Journal method.  What are you looking to determine?
We are looking to see if cancer patients entering a workshop anonymously, as would any citizen or person, would experience some form of meaningful support from the process.  This could be manifested in their general attitudes and well-being, their outlook on life, and possibly the solution of practical problems.

Describe how the study is structured.  Will patients be attending workshops?   How will you be monitoring their experiences?
At this point, weíve created an advisory board of medical faculty, support staff, and patients, who will hear a presentation from a certified leader (John McMurry) about the Intensive Journal Program and will discuss it within the context of cancer care.  After this, we will formulate a proposal, to look at the effect of workshop participation on the overall well being of cancer patients.  Initially, we plan to have the workshop take place in its normal setting so that participants can enter in an anonymous way as we hope not to alter the workshop experience.  The actual journals that the patients produce in the workshop will be kept private as they always are.  We are looking into the effect of the experience, not reading the journals.

What outcomes do you expect to see from this study?
We would initially formulate a hypothesis that an intervention would produce an improvement of quality of life measurements.  We would use quality of life tools administered before and after to look at the differences.  In addition, we would look for further leads in open-ended interviews and additional writings and written comments that the participants provide including narrative descriptions of their experience.  I will be looking from the quantitative and qualitative point of view.

Is there anything else you would like to tell us?
Iím very optimistic about the potential of the Intensive Journal method to help patients solve problems of meaning that serious illness brings up.  Because of the unique aspects of the Intensive Journal method that include structure, feedback, and group support, I think there is greater potential of longer lasting improvement than from other group experiences.  It will also be complementary to other group support.