Psychosocial Therapy and Support for Cancer Patients
I have said these:
ROJoson Cancer Crusaders Club
“Through the Cancer Crusaders Club, I intend to administer psychosocial therapy on my cancer patients.”
PSYCHOSOCIAL THERAPY AND SUPPORT
ROJoson will revisit, refine and enhance starting Sept. 2020!
I will come out with a refined operational definition.
What is the concept of psychosocial therapy and support?
First of all, let’s consider the reactions of the cancer patients that will lead to a need for psychosocial therapy and support.
Patients with cancers can be asymptomatic (no physical symptoms) or symptomatic (with physical symptoms)
Asymptomatic (based on physical symptoms) – usually no psychological reactions
Symptomatic (based on physical symptoms) – usually with psychological and psychosocial reactions
Psychological reactions
Psychological reactions involving self only (personal – fear of death – fear of disability – fear of loss of monetary income - others)
“Psychological” means “of, affecting, or arising in the mind; related to the mental and emotional state of a person” (Oxford English Dictionary).
Psychosocial reactions
Psychological reactions with influence of social factors (psychosocial)
“Psychosocial” means “pertaining to the influence of social factors on an individual's mind or behavior, and to the interrelation of behavioral and social factors” (Oxford English Dictionary).
Psychological + Psychosocial Reactions
Psychological reactions may initially be purely psychological reactions involving self only and usually eventually becoming psychosocial reactions.
PSYCHOLOGICAL DISTRESS
The psychological and psychosocial reactions of cancer patients can be lumped together under the term “PSYCHOLOGICAL DISTRESS.”
PSYCHOLOGICAL DISTRESS
The psychological and psychosocial reactions of cancer patients can be lumped together under the term “PSYCHOLOGICAL DISTRESS.”
Psychological distress – either present or absent in a cancer patient
Psychological distress is a general term used to describe unpleasant feelings or emotions that impact a person’s level of functioning. In other words, it is psychological discomfort that interferes with the person’s activities of daily living. It may be mild, moderate or severe to point of being categorized as mental illness. The feelings may be sadness, anxiety and depression.
No two people experience one event the exact same way. Psychological distress is a subjective experience. That is, the severity of psychological distress is dependent upon the situation and how a person perceives it. One can think of psychological distress as a continuum with 'mental health' and 'mental illness' at opposing ends. As one continues to experience different things at different times, one can travel back and forth on the continuum at different times throughout one’s life.
Level or degree of functioning determines the level or degree of psychological distress or vice versa.
Level or degree of coping determines the level of functioning and/or level of psychological distress.
Ultimately, how functional a person with a cancer will be is the what matters most. If he is coping well, he is expected to be functional or to function well. The psychological distress is assumed to be controlled.
Being functional can be equated with quality of life or least it contributes to quality of life.
A cancer patient being completely functional means one can still do self-care and be productive as a member of a family and citizen of a community.
A cancer patient being non-functional means one cannot totally do self-care and cannot be productive as a citizen in the community.
A cancer patient may have some physical impairment in terms of limitations to carry out certain functions in daily lives because of the cancer disease itself. Thus, physical impairment may at times with equated to physical disability. However, even with some physical impairment, a cancer patient may still be functional in terms self-care with assistance as needed and still be productive as a member of a family and citizen of a community.
A cancer patient who has no physical impairment may not be functional if he has mental and emotional impairment.
Thus, in a cancer patient, it is important that there must be adequate coping to achieve optimal level of functioning. This eventually contributes to quality of life.
A psychological distress can occur in any of these phases of cancer life cycle:
• Finding a suspicious symptom
• Being informed about the diagnosis
• Awaiting treatment
• Change or end of treatment
• Discharge from hospital
• Surviving cancer
• Failure of treatment
• Recurrence or progression of disease
• Advanced phase of illness
• Approaching the end of life
Reactions to cancer could be purely psychological or psychosomatic.
Reactions can be sadness, anxiety and depression. Severity will vary from one person to another.
Coping will vary from one person to another.
Level of functionality will also vary from one person to another depending on how he copes and how successful he copes with or without the aid of relatives, friends, and physicians.
Psychosocial Therapy and Support
All cancer patients usually have psychosocial reactions and not purely psychological reactions.
Thus, in managing or helping cancer patients, psychosocial therapy and support is usually done comprehensively.
Psychosocial therapy and support should be looked at as a continuum with support and therapy (treatment) at opposing ends and they can travel back and forth on the continuum at different times throughout the patient cancer journey.
Therapy is operationally defined as one that consists of an intensive treatment and which usually needs a psychiatrist to come into the picture. Support is of lesser extent than therapy, usually involving non-use of “psychiatric” medicines (such as anxiolytics, hypnotics and sedatives, antidepressants and antipsychotics).
Support by whatever means is usually given by the oncologists or primary health care physicians; relatives; and support groups. Therapy is usually given by a psychiatrist.
Coping without therapy can be initiated by the patient himself. He may need psychosocial support. Hopefully, he may not have to seek the help of a psychiatrist.
To be tackled:
How to cope (by the patient himself)
How to provide psychosocial support by the oncologists or primary health care physicians
How to provide psychosocial support by the relatives
How to provide / get psychosocial support from cancer support groups