Reflective accounts

Psychological support

I read the CPD article to improve my knowledge of the psychological needs of people living with cancer. Half of these people (150,000 per year) experience anxiety or depression after a diagnosis of cancer.

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A comprehensive psychological assessment of the patient should be undertaken at the time of cancer diagnosis, which examines their history, context and functioning. An in-depth risk assessment is required for patients with very low mood, feelings of hopelessness, suicidal ideation, a history of self-harm, poor reality testing, suspected substance misuse or a lack of social support.

When patients are nearing the end of their lives, psychological difficulties can include anger, fatigue, helplessness, mood disturbances, depression, anxiety, adjustment disorders, substance misuse, interpersonal problems, suicidal ideation or self-harm, pain and grief.

Stressors that can occur over the course of a patient’s illness include: altered interpersonal relationships, independence issues, achievement-orientated goals and activities, existential issues, body image and integrity.

Psychometric questionnaires can be used to identify physical, psychological, social or spiritual needs that may have been overlooked. It is vital to ensure that assistance and support are available to all patients psychologically affected by cancer.

The article discussed the different psychotherapy approaches available for managing depression, anxiety, stress, low self-esteem or coping difficulties. These approaches include cognitive behavioural therapy, mindfulness based stress reduction, acceptance and commitment therapy and existential therapy.

An individualised approach should be used to determine which coping strategies will help patients to manage the challenges associated with their particular illness and healthcare needs.

Importance of self-care

The CPD article emphasised that caring for patients diagnosed with cancer can be challenging and stressful, and may cause chronic stress, burnout and ill health. Engaging in good self-care can help to overcome this.

Self-care may involve accessing support and supervision, setting boundaries between work and home, debriefing and being aware of stress levels in other members of the multidisciplinary team.

Guidance suggests that everyone involved in providing psychological care for patients with cancer should be expertly trained and supervised.

National and regional schemes offer training in advanced psychological skills, communication techniques and experiential learning.

I intend to research which courses teach psychological assessment and support skills, so that I can develop my knowledge and practice in this area of care.

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