October 6, 2018

Counseling for Individuals with a Cancer Diagnosis

Posted in cognitive behavioral therapy, Well-being tagged , , at 6:35 am by kellyfdennis


Cancer is the number two killer in the United States after heart disease. One in every four people will develop cancer. In general, there are three basic forms of cancer based on the part of the body that is affected: sarcomas (bone or soft tis- sue), carcinomas (surface tissue, such as lung, breast, colon), and leukemias or lymphomas (bone marrow or lymph nodes). (Read the full ACBT article here)

When individuals are first diagnosed with cancer there is often a reaction of disbelief accompanied by many negative emotions, which can include depression, anxiety, and extreme fear. Fears include apprehension about the disease itself, its treatment, doubts about the success of the treatment, and how the cancer and its treatment may affect one’s life. Physical and psychological reactions can change over time (for instance, with a change in type of treatment, or after fol- low-up tests, etc.) as the cancer either gets worse or goes away. Generally, the more widespread the disease, and the more physical impairment or disfigure- ment, the more difficult it may be to adjust psychologically to the disease. Difficulties in adjustment can interfere with day to day living, work, and relation- ships with significant others.

What Is Coping? What Affects Coping?

The better a patient can cope with the cancer, the more likely that he or she can enjoy a better quality of life. In order to deal with cancer, individuals engage in behaviors to directly address the disease; for example, choosing a problem-oriented approach to help with decisions around the type of treat- ment and where the treatment will be taken. Other, more personal, examples include redefining self-worth and realizing one’s control over the disease process. Having a reason to live, such as caring for a family, wanting to con- tribute to a business or charity, or continuing a favorite hobby, is especially helpful in coping with cancer.

An individual’s ability to cope is affected by the cancer’s severity, how far it has spread, the degree of physical debilitation, the person’s view of himself or herself and his or her purpose in life, social supports, and whether the cancer is terminal.

Positive relationships with others help the patient adjust. Individuals need to feel that they can develop and maintain warm and trusting relationships. How friends and family adjust to the diagnosis can greatly affect the cancer patient’s ability to cope with the disease. If family and friends react with denial or disbelief, or blame the patient for causing the cancer, this may lead to poorer adjustment. Conversely, having friends and family who accept the diagnosis and maintain the same warm and close relationship that existed before helps the cancer patient’s adjustment. Care providers who are open, who provide accurate information regarding disease expectations, outcomes, and sensory experiences greatly assist the cancer patient’s ability to cope with this traumatic illness.

Behavior Therapy

One area that has been the focus of most of the research for psychological interventions is the use of relaxation training (learning to relax certain muscle groups, or biofeedback) to reduce chemotherapy treatment side effects. Relaxation training is effective in reducing anxiety, nausea, and vomiting, both before and after chemotherapy. Strategies for reducing stress, including relaxation training and education about particular medical procedures, also help reduce anxiety and increase compliance with the doctor’s treatment rec- ommendations.

There are several goals in the use of behavior therapy with cancer patients. The first goal is to help the individual learn to problem solve around dealing with the disease, its treatment and side effects, and to increase feelings of con- trol over the disease. The second goal of behavior therapy approaches is to address specific problems, such as sexual dysfunction, which the cancer or cancer treatment(s) may cause. A third goal of behavioral approaches is to deal with compliance issues that may directly affect the success of medical treatments for the cancer.

Cognitive Behavior Therapy

Individuals with cancer often have many fears and misconceptions about the disease, its outcome, its treatments, and their own ability to cope. Cognitive behavioral approaches can help patients to identify negative beliefs that may hinder their ability to accept the diagnosis and cope with the disease. Once dysfunctional beliefs are identified, individuals can challenge these neg- ative thoughts, develop more rational responses, and think more positively, particularly regarding their role in adjusting to the disease. The ability to examine negative thoughts objectively and to replace them with more posi- tive, adaptive thoughts greatly enhances quality of life. Cognitive therapies are also used to help individuals who are terminally ill to accept or reduce their fear of death and dying. Other cognitive strategies involve imagery in conjunc- tion with relaxation training.


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