What You Need To Know About Psychotherapy If You Have Cancer

Each person has a different belief system and personal way of coping. This is why psychotherapeutic support is not a one-size-fits-all and has a broad range of modalities they can help people and psychologists understand certain attitudes and thoughts. In this article you will identify which therapeutic "language" or approach best aligns with your current needs and personality. 

What is psychotherapy? 

Psychotherapy is also known as "talk therapy." It is an evidence-based treatment where you work with a trained mental health professional, such as a psychologist or psychiatrist.  Psychotherapy helps you understand your emotions, thoughts, and behaviors. 

Therapy is not just for people who have been diagnosed with a mental illness, such as anxiety or depression. It is a versatile tool that can benefit anyone facing life's stresses, from relationship conflicts and grief to adjusting to a serious medical condition.

Psychotherapy helps identify what causes distress in each person, enabling deeper healing and better daily functioning. It provides a safe, non-judgmental environment to discover your own resilience and learn healthy coping skills for facing future challenges.

There’s a type of psychotherapy for every need 

Psychotherapy is not a one-size-fits-all process. There are different types of psychotherapy, so it is important to talk to a licensed professional about what would be best for your needs and preferences. 

Each type guides therapists through your specific problems and determines which solutions will be most effective for your unique situation. For example, a therapist using a cognitive behavioral roadmap will focus on changing unhealthy thinking patterns, while one using a psychodynamic roadmap will explore how your past experiences influence your present behavior.

Psychologists use five broad categories as roadmaps to understand human behavior and guide the therapeutic process. Each school offers a different perspective on how mental health challenges develop and how they can be solved.

Core Focus

Key Techniques & Concepts

Psychoanalysis & Psychodynamic

Changing behavior by discovering unconscious meanings and motivations.

Helps you learn about yourself by understanding how past experiences affect you today.

Behavior Therapy

The role of learning in developing both normal and abnormal behaviors.

Classical conditioning: Associative learning, such as "desensitizing" for phobias. 

Operant conditioning: Shaping behavior through rewards and punishments.

Cognitive Therapy

Emphasizes what people think rather than what they do.

Identifying and changing dysfunctional thinking patterns to improve emotions and actions. Often combined with behavior therapy as cognitive-behavioral therapy.

Humanistic Therapy

Emphasizes the capacity to make rational choices and develop to maximum potential.

Client-Centered: Prioritizes therapist care over "authority". 

Gestalt: Focuses on "here and now" awareness. 

Existential: Focuses on free will and the search for meaning.

Integrative or Holistic

A blend of elements from different approaches tailored to the individual's needs.

Highly flexible: allows therapists to customize treatment based on the client's unique personality and specific life challenges.

A specialized therapy for advanced illness: The CALM approach

For people facing advanced or life-threatening diseases, traditional psychotherapy may not always address the unique pressures of a terminal diagnosis. Managing Cancer and Living Meaningfully (CALM) is a brief, evidence-based approach designed specifically to fill this gap. It provides a psychological framework to help patients relieve distress and promote psychological growth while navigating their illness.

At the heart of CALM is the therapeutic strategy of encouraging "double awareness." This is the capacity to acknowledge and face the difficult realities of physical deterioration and mortality while simultaneously maintaining an active engagement with life. By creating a safe space to discuss death and dying, CALM helps patients move away from the mutual avoidance of these topics. Avoiding difficult topics may require more emotional energy, but it rewards people with resilience and inner peace.

The four domains of CALM

CALM therapy is typically delivered over three to six sessions, focusing on four broad and interrelated areas of the patient's life:

• Symptom management and healthcare relationships: This domain focuses on the patient's physical symptoms and functioning. It helps patients take an active role in their medical care and fosters collaborative, effective relationships with their healthcare providers for better medical decision-making.

Changes in self and relations with close others: Advanced illness often leads to a loss of social roles and life goals. CALM facilitates the expression of grief regarding these losses and helps patients manage the anxieties of becoming dependent on family or friends.

Sense of meaning and purpose: This domain addresses a patient’s spiritual beliefs and their search for meaning in the face of advanced disease. It encourages a reevaluation of personal priorities and values to understand the personal meaning of suffering.

The future, hope, and mortality: The final domain addresses the fears and hopes associated with the end of life. It facilitates open discussions about death preparation, life closure, and advanced care planning to reduce death-related anxiety.

Research has shown that this approach is highly effective; a large trial demonstrated that CALM therapy significantly improved depressive symptoms and end-of-life preparation compared to usual care. By being "seen as a whole person" within the healthcare system, patients are empowered to live as meaningfully as possible, regardless of their prognosis.

Psychotherapy can be a powerful step to get better inside and out

Many people facing a cancer diagnosis may require the support of a mental health professional to guide them through an empathetic, resilient approach. It is crucial to normalize the need for mental health intervention in these moments. 

Anxiety and depression are medical conditions and they are common responses to the trauma of a life-altering illness. Just as you seek medical treatment for physical symptoms, seeking psychotherapeutic support is a vital, legitimate part of your recovery that can improve your overall quality of life and psychosocial adjustment.

Actionable Steps for Patients and Caregivers

Taking the first step toward psychotherapeutic support requires identifying your personal goals.  Because cancer affects both the individual and their support system, these actionable steps can help you and your loved ones navigate the process effectively:

• Identify your primary goals: Determine if you are seeking to change a specific behavior, such as improving sleep habits (Behavior Therapy), reframing negative thought patterns about your diagnosis (Cognitive Therapy), or finding existential meaning in the face of advanced illness (Existential or CALM Therapy).
• Embrace the collaborative model: Effective therapy in an oncology setting is a joint effort between clinical doctors and therapists to help patients. It should address both practical needs, such as navigating healthcare decisions and symptom management, and existential concerns, such as maintaining hope and preparing for the future.
• Consider the patient-Caregiver dyad: You may choose to bring a designated caregiver or family member into your sessions. This "dyad" approach can help resolve relational strain, improve spousal communication, and ensure that caregivers also receive the support and psychoeducation they need to manage their own distress.
• Communicate with your oncology team: Discuss your interest in psychotherapy with your doctors to ensure your care is well-coordinated and that any pharmacological treatments for mental health are screened for interactions with your cancer medications.

Finding strength in the right roadmap

Psychotherapy is a personalized support where the "roadmap" used by your therapist, whether it is Cognitive-Behavioral, Humanistic, or a specialized approach like CALM, must align with your unique personality and needs. By selecting the right therapeutic framework, you can approach your health with greater resilience and compassion.

May is mental health awareness month, and we would love to remind you that mental wellness is a vital and legitimate component of medical treatment. Addressing the psychological dimension of cancer does more than just alleviate immediate distress; it promotes psychological growth, improves overall quality of life, and empowers you to remain an active participant in your recovery and your life.

With the right support and the right roadmap, it is possible to find strength, clarity, and meaning, regardless of the challenges ahead.

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Sources: 

• American Psychological Association Different approaches to psychotherapy

• American Journal of Psychotherapy: Psychotherapeutic Approach for Advanced Illness: Managing Cancer and Living Meaningfully (CALM) Therapy