My practice will entail addressing the personal/psychological/emotional needs of oncology patients by:
The stresses of living with a diagnosis of cancer can be a daily struggle, both physically and psychologically. Depression, anxiety, dependency, vulnerability, guilt, sadness, anger, grief, embarrassment, rejection, mood disturbances, fear of recurrence or further physical damage are what many cancer survivors live with on a day to day basis. And always the fear of death from the cancer is what a client lives with. Such issues come isolated, but usually are multiple. These conflicts may grow and adversely affect a client’s life. This is why counseling is so necessary. I believe that the mental needs of a client are as significant as their physical needs. Often the physical wounds of surgical and medical treatments heal, but scars can result. Often the client wears these scars on the outside, but all the time on the inside.
My approach is to learn what opportunities are now closed because of a diagnosis of cancer, and help the client to see for themselves what new doors are open to them. Counseling gives the client a non-bias outlook on one’s self that sometimes friends and family cannot accomplish.
With some cancer patients, death and dying may be a reality, with no hope of recovery. There is an adaptation of psychotherapy to a more existential and humanistic position. Behavioral approaches are often employed. The individual circumstances and special needs are addressed. Assisting in resolving some conflicts or life regrets is essential. It is a time limited and time focused therapy. Careful coordination with other family and para-professionals is required. The most stable person can be in despair and anguish when facing death.
Some patients may exhibit depression, anxiety, anger, denial, loneliness, regression, alienation or withdrawal. There is much emotional interaction. Flexibility, self-actualization, and life context are important in this stage of counseling.
Counseling a dying client in different age groups requires an understanding of how the complexities change and vary, and may be age dependent in client reactions and therapeutic modalities. I understand that pre-existing emotional/mental issues may exacerbate at this critical time. Spirituality may be needed as part of counseling, but is never imposed upon the client. Dignity is a high priority. The client will need help focusing on whatever qualities of life that remain. Clients may also need support in their final decision making. Ritualistic behaviors are well founded and shared with the therapist.
Oncology counseling is necessary for loved ones of the deceased. The emotional reactions are quite similar to the emotions experienced by the dying patient. As with a dying patient, grieving clients do not always follow an orderly and stepwise progression of denial through acceptance. Special situations are understood and ritualistic therapy is offered and discussed.
Cancer counseling is a much needed, and under-utilized, under –recognized branch of mental health. Cancer will affect 4 out of 10 Americans. Due to early diagnosis and successful treatment, cancer can be cured and even managed as a chronic disease.