List of Contributors xi
Foreword xv
Preface xvii
Section A: Individual Models of Therapy 1
Chapter 1 Supportive Psychotherapy in Cancer Care: an Essential Ingredient of All Therapy 3
1.1 Introduction 3
1.2 Definition 3
1.3 History and Evidence Base 4
1.4 Qualifications for Clinical Privileges to Provide Supportive Psychotherapy as a
Psycho-Oncologist 4
1.5 Application of Supportive Therapy in Cancer Care 4
1.6 Boundaries in the Therapy Relationship: Therapeutic Activism 7
1.7 Themes Met in Advanced Cancer 8
1.8 Families as Part of Patients’ Supportive Psychotherapy 10
1.9 Therapist Issues 12
1.10 Service Development Issues 13
Recommended Reading & Resources 13
References 14
Chapter 2 Cognitive-Behavioural Therapies in Cancer Care 15
2.1 Background 15
2.2 Processes and Techniques 18
2.3 Case Examples 21
2.4 Evidence on Efficacy 23
2.5 Service Development 23
2.6 Summary 24
2.7 Supporting Materials 24
References 24
Chapter 3 Cognitive Analytic Therapy in Psycho-Oncology 27
3.1 Introduction 27
3.2 Theoretical Background of CAT 27
3.3 CAT Concepts and Cancer 28
3.4 Process of Application of CAT in Cancer Care 29
3.5 Supporting Materials 32
3.6 A Brief Overview of Evidence on Efficacy 33
3.7 Target Groups of Patients for Whom CAT Is Appropriate 33
3.8 Case Example 33
Contents
3.9 What Can CAT Offer in a Cancer Setting? 36
3.10 Service Development: Integrating CAT into Psycho-Oncology Services 36
3.11 Conclusion 36
Acknowledgements 36
References 36
Chapter 4 Mindfulness Interventions for Cancer Patients 39
4.1 Introduction 39
4.2 Mindfulness-Based Stress Reduction 39
4.3 Content and Processes of Mindfulness-Based Interventions 40
4.4 Case Example 44
4.5 Efficacy of MBSR and Mindfulness Interventions 45
4.6 Service Development 46
4.7 Summary 46
Recommended Reading 46
References 47
Chapter 5 Relaxation and Image Based Therapy 49
5.1 Background 49
5.2 Evidence on Efficacy 52
5.3 Processes and Techniques 53
5.4 Case Example 54
5.5 Service Development 56
5.6 Summary 57
References 57
Chapter 6 Motivational Counselling in Substance Dependence 59
6.1 Background 59
6.2 Processes and Techniques 61
6.3 Case Example 64
6.4 Evidence on Efficacy 66
6.5 Service Development 67
6.6 Summary 67
Acknowledgements 67
References 67
Chapter 7 Narrative Therapy 69
7.1 Background 69
7.2 Processes and Techniques 70
7.3 Case Example 75
7.4 Evidence on Efficacy 77
7.5 Service Development 77
7.6 Summary 77
References 77
Chapter 8 Dignity Therapy 79
8.1 Introduction 79
8.2 Background of Dignity Research 79
8.3 The Conduct of Dignity Therapy: Processes and Techniques 82
8.4 The Therapist’s Role 85
8.5 Evidence of the Efficacy of Dignity Therapy 86
8.6 Service Development 87
8.7 Conclusion and Future Directions 87
Acknowledgements 88
References 88
Chapter 9 Written Emotional Disclosure 89
9.1 Background 89
9.2 Evidence on Efficacy 91
9.3 Target Patients 95
9.4 Processes and Techniques 97
9.5 Appendix: Sample Instructions for Expressive Writing for Cancer Patients and
Survivors 99
References 100
Section B: Group Models of Therapy 105
Chapter 10 Supportive-Expressive Group Psychotherapy 107
10.1 Introduction 107
10.2 Theoretical Background and Themes 107
10.3 Goals of Supportive-Expressive Groups 108
10.4 Target Groups of Patients for Whom It Is Appropriate 110
10.5 Processes and Techniques 110
10.6 Case Example 112
10.7 Evidence for Efficacy of SEGT 114
10.8 Service Development 114
Recommended Reading 115
References 115
Chapter 11 A Short Term, Structured, Psychoeducational Intervention for Newly Diagnosed Cancer
Patients 119
11.1 Introduction 119
11.2 Theoretical Background and Themes of Our Psychoeducational Model 119
11.3 Target Groups of Patients and Evidence of Efficacy of the Structured Psychoeducational
Group Intervention 122
11.4 Process, Techniques and Case Example 125
11.5 Service Development 132
11.6 Summary 132
References 133
Chapter 12 Meaning-Centered Group Psychotherapy 137
12.1 Introduction 137
12.2 Background 137
12.3 Theoretical Conceptual Framework Underlying Meaning-Centred
Psychotherapy 138
12.4 Target Groups of Patients 139
12.5 Main Themes and Format of the Therapy 140
12.6 Key Therapist Techniques in the Application of MCGP 144
12.7 Case Example 145
12.8 Key Challenges in Application of MCGP 146
12.9 Overview of Evidence on Efficacy 146
12.10 Service Development and Future Directions 146
12.11 Summary 146
Acknowledgement 147
Recommended Reading 147
References 147
Chapter 13 Couple-Focused Group Intervention for Women with Early Breast Cancer and Their
Partners 149
13.1 Background 149
13.2 Intervention Strategies and Main Themes of the Couple-Focused Group (CFG) 151
13.3 Evidence on Efficacy 152
13.4 Processes and Techniques 153
13.5 Case Example 155
13.6 Service Development 155
13.7 Summary 156
13.8 Supporting Materials 157
Acknowledgements 157
References 157
Section C: Couple and Family Therapies 159
Chapter 14 Couples Therapy in Advanced Cancer: Using Intimacy and Meaning to Reduce Existential
Distress 161
14.1 Introduction 161
14.2 Integrating Meaning-Making and Intimacy: Working Models 162
14.3 Processes: Structure and Overview of Therapy 164
14.4 Couple Exercises and Case Examples 169
14.5 Evidence on Efficacy 171
14.6 Service Development 171
14.7 Summary 172
Recommended Reading 172
References 172
Chapter 15 Therapies for Sexual Dysfunction 175
15.1 Background 175
15.2 Processes and Techniques 178
15.3 Case Examples 178
15.4 Evidence on Efficacy 180
15.5 Service Development 180
15.6 Summary 180
15.7 Supporting Materials 180
Acknowledgements 182
References 182
Chapter 16 Focused Family Therapy in Palliative Care and Bereavement 185
16.1 Theoretical Background 185
16.2 Target Groups of Patients 186
16.3 Main Themes and Format of the Therapy 186
16.4 Therapy Processes and Techniques 188
16.5 Supporting Materials 194
16.6 Overview of Evidence on Efficacy 194
16.7 Case Examples 194
16.8 Service Development 196
16.9 Summary 196
Acknowledgement 196
Recommended Reading 196
References 196
Section D: Therapies Across the Life Cycle 199
Chapter 17 Therapy in the Setting of Genetic Predisposition to Cancer 201
17.1 Background 201
17.2 Counselling and Psychotherapeutic Interventions 204
17.3 Case Example 207
17.4 Evidence on Efficacy 209
17.5 Service Development 209
17.6 Summary 209
17.7 Supporting Materials 209
References 210
Chapter 18 Psychotherapy with Paediatric and Adolescent Cancer Patients 213
18.1 Introduction 213
18.2 Assessment 213
18.3 Service Development 215
18.4 Treatment Selection: Methods, Techniques and Efficacy 216
18.5 Issues in Treatment 217
18.6 Case Discussion: a Multidisciplinary Team Approach 220
18.7 Summary 222
References 222
Chapter 19 Therapy for Parental Cancer and Dependent Children 225
19.1 Background 225
19.2 Theoretical and Evidence-Based Rationale 225
19.3 Components of the Programme 229
19.4 Evidence for Efficacy 231
19.5 Summary of the Training Programme 232
19.6 Current and Future Directions 232
References 233
Chapter 20 Psychosocial Interventions for Elderly Cancer Patients 235
20.1 Introduction 235
20.2 Cancer in the Elderly: Clinical Evaluation 235
20.3 Quandaries and Reliability of Interventions 236
20.4 Psychosocial Theories on Ageing: Basis for Interventions 236
20.5 Elderly Cancer Patient Interventions 238
20.6 Forgiveness: Life – Illness – Death 240
20.7 Cognitive-Behavioural Therapy 241
20.8 Life and Hope: Transforming Fear into Hope 242
20.9 Selected Therapies: Intervention Techniques with Groups of Elderly
Cancer Patients 243
20.10 Case Examples 243
Contents
20.11 Overview of Evidence for Therapeutic Benefit 244
20.12 Conclusion 244
References 244
Chapter 21 Reconstructing Meaning in Bereavement 247
21.1 The Clinical Context 247
21.2 Theoretical Perspectives: the Changing Landscape of Loss 247
21.3 Grief and the Quest for Meaning 249
21.4 Techniques for Reconstructing Meaning in Loss 251
21.5 Clinical Illustration of Therapy as Meaning Reconstruction 254
21.6 Overview of Efficacy of Meaning-Making Interventions 255
21.7 Service Development to Build a Programme 255
21.8 Conclusion 255
References 256
Index 259
Foreword xv
Preface xvii
Section A: Individual Models of Therapy 1
Chapter 1 Supportive Psychotherapy in Cancer Care: an Essential Ingredient of All Therapy 3
1.1 Introduction 3
1.2 Definition 3
1.3 History and Evidence Base 4
1.4 Qualifications for Clinical Privileges to Provide Supportive Psychotherapy as a
Psycho-Oncologist 4
1.5 Application of Supportive Therapy in Cancer Care 4
1.6 Boundaries in the Therapy Relationship: Therapeutic Activism 7
1.7 Themes Met in Advanced Cancer 8
1.8 Families as Part of Patients’ Supportive Psychotherapy 10
1.9 Therapist Issues 12
1.10 Service Development Issues 13
Recommended Reading & Resources 13
References 14
Chapter 2 Cognitive-Behavioural Therapies in Cancer Care 15
2.1 Background 15
2.2 Processes and Techniques 18
2.3 Case Examples 21
2.4 Evidence on Efficacy 23
2.5 Service Development 23
2.6 Summary 24
2.7 Supporting Materials 24
References 24
Chapter 3 Cognitive Analytic Therapy in Psycho-Oncology 27
3.1 Introduction 27
3.2 Theoretical Background of CAT 27
3.3 CAT Concepts and Cancer 28
3.4 Process of Application of CAT in Cancer Care 29
3.5 Supporting Materials 32
3.6 A Brief Overview of Evidence on Efficacy 33
3.7 Target Groups of Patients for Whom CAT Is Appropriate 33
3.8 Case Example 33
Contents
3.9 What Can CAT Offer in a Cancer Setting? 36
3.10 Service Development: Integrating CAT into Psycho-Oncology Services 36
3.11 Conclusion 36
Acknowledgements 36
References 36
Chapter 4 Mindfulness Interventions for Cancer Patients 39
4.1 Introduction 39
4.2 Mindfulness-Based Stress Reduction 39
4.3 Content and Processes of Mindfulness-Based Interventions 40
4.4 Case Example 44
4.5 Efficacy of MBSR and Mindfulness Interventions 45
4.6 Service Development 46
4.7 Summary 46
Recommended Reading 46
References 47
Chapter 5 Relaxation and Image Based Therapy 49
5.1 Background 49
5.2 Evidence on Efficacy 52
5.3 Processes and Techniques 53
5.4 Case Example 54
5.5 Service Development 56
5.6 Summary 57
References 57
Chapter 6 Motivational Counselling in Substance Dependence 59
6.1 Background 59
6.2 Processes and Techniques 61
6.3 Case Example 64
6.4 Evidence on Efficacy 66
6.5 Service Development 67
6.6 Summary 67
Acknowledgements 67
References 67
Chapter 7 Narrative Therapy 69
7.1 Background 69
7.2 Processes and Techniques 70
7.3 Case Example 75
7.4 Evidence on Efficacy 77
7.5 Service Development 77
7.6 Summary 77
References 77
Chapter 8 Dignity Therapy 79
8.1 Introduction 79
8.2 Background of Dignity Research 79
8.3 The Conduct of Dignity Therapy: Processes and Techniques 82
8.4 The Therapist’s Role 85
8.5 Evidence of the Efficacy of Dignity Therapy 86
8.6 Service Development 87
8.7 Conclusion and Future Directions 87
Acknowledgements 88
References 88
Chapter 9 Written Emotional Disclosure 89
9.1 Background 89
9.2 Evidence on Efficacy 91
9.3 Target Patients 95
9.4 Processes and Techniques 97
9.5 Appendix: Sample Instructions for Expressive Writing for Cancer Patients and
Survivors 99
References 100
Section B: Group Models of Therapy 105
Chapter 10 Supportive-Expressive Group Psychotherapy 107
10.1 Introduction 107
10.2 Theoretical Background and Themes 107
10.3 Goals of Supportive-Expressive Groups 108
10.4 Target Groups of Patients for Whom It Is Appropriate 110
10.5 Processes and Techniques 110
10.6 Case Example 112
10.7 Evidence for Efficacy of SEGT 114
10.8 Service Development 114
Recommended Reading 115
References 115
Chapter 11 A Short Term, Structured, Psychoeducational Intervention for Newly Diagnosed Cancer
Patients 119
11.1 Introduction 119
11.2 Theoretical Background and Themes of Our Psychoeducational Model 119
11.3 Target Groups of Patients and Evidence of Efficacy of the Structured Psychoeducational
Group Intervention 122
11.4 Process, Techniques and Case Example 125
11.5 Service Development 132
11.6 Summary 132
References 133
Chapter 12 Meaning-Centered Group Psychotherapy 137
12.1 Introduction 137
12.2 Background 137
12.3 Theoretical Conceptual Framework Underlying Meaning-Centred
Psychotherapy 138
12.4 Target Groups of Patients 139
12.5 Main Themes and Format of the Therapy 140
12.6 Key Therapist Techniques in the Application of MCGP 144
12.7 Case Example 145
12.8 Key Challenges in Application of MCGP 146
12.9 Overview of Evidence on Efficacy 146
12.10 Service Development and Future Directions 146
12.11 Summary 146
Acknowledgement 147
Recommended Reading 147
References 147
Chapter 13 Couple-Focused Group Intervention for Women with Early Breast Cancer and Their
Partners 149
13.1 Background 149
13.2 Intervention Strategies and Main Themes of the Couple-Focused Group (CFG) 151
13.3 Evidence on Efficacy 152
13.4 Processes and Techniques 153
13.5 Case Example 155
13.6 Service Development 155
13.7 Summary 156
13.8 Supporting Materials 157
Acknowledgements 157
References 157
Section C: Couple and Family Therapies 159
Chapter 14 Couples Therapy in Advanced Cancer: Using Intimacy and Meaning to Reduce Existential
Distress 161
14.1 Introduction 161
14.2 Integrating Meaning-Making and Intimacy: Working Models 162
14.3 Processes: Structure and Overview of Therapy 164
14.4 Couple Exercises and Case Examples 169
14.5 Evidence on Efficacy 171
14.6 Service Development 171
14.7 Summary 172
Recommended Reading 172
References 172
Chapter 15 Therapies for Sexual Dysfunction 175
15.1 Background 175
15.2 Processes and Techniques 178
15.3 Case Examples 178
15.4 Evidence on Efficacy 180
15.5 Service Development 180
15.6 Summary 180
15.7 Supporting Materials 180
Acknowledgements 182
References 182
Chapter 16 Focused Family Therapy in Palliative Care and Bereavement 185
16.1 Theoretical Background 185
16.2 Target Groups of Patients 186
16.3 Main Themes and Format of the Therapy 186
16.4 Therapy Processes and Techniques 188
16.5 Supporting Materials 194
16.6 Overview of Evidence on Efficacy 194
16.7 Case Examples 194
16.8 Service Development 196
16.9 Summary 196
Acknowledgement 196
Recommended Reading 196
References 196
Section D: Therapies Across the Life Cycle 199
Chapter 17 Therapy in the Setting of Genetic Predisposition to Cancer 201
17.1 Background 201
17.2 Counselling and Psychotherapeutic Interventions 204
17.3 Case Example 207
17.4 Evidence on Efficacy 209
17.5 Service Development 209
17.6 Summary 209
17.7 Supporting Materials 209
References 210
Chapter 18 Psychotherapy with Paediatric and Adolescent Cancer Patients 213
18.1 Introduction 213
18.2 Assessment 213
18.3 Service Development 215
18.4 Treatment Selection: Methods, Techniques and Efficacy 216
18.5 Issues in Treatment 217
18.6 Case Discussion: a Multidisciplinary Team Approach 220
18.7 Summary 222
References 222
Chapter 19 Therapy for Parental Cancer and Dependent Children 225
19.1 Background 225
19.2 Theoretical and Evidence-Based Rationale 225
19.3 Components of the Programme 229
19.4 Evidence for Efficacy 231
19.5 Summary of the Training Programme 232
19.6 Current and Future Directions 232
References 233
Chapter 20 Psychosocial Interventions for Elderly Cancer Patients 235
20.1 Introduction 235
20.2 Cancer in the Elderly: Clinical Evaluation 235
20.3 Quandaries and Reliability of Interventions 236
20.4 Psychosocial Theories on Ageing: Basis for Interventions 236
20.5 Elderly Cancer Patient Interventions 238
20.6 Forgiveness: Life – Illness – Death 240
20.7 Cognitive-Behavioural Therapy 241
20.8 Life and Hope: Transforming Fear into Hope 242
20.9 Selected Therapies: Intervention Techniques with Groups of Elderly
Cancer Patients 243
20.10 Case Examples 243
Contents
20.11 Overview of Evidence for Therapeutic Benefit 244
20.12 Conclusion 244
References 244
Chapter 21 Reconstructing Meaning in Bereavement 247
21.1 The Clinical Context 247
21.2 Theoretical Perspectives: the Changing Landscape of Loss 247
21.3 Grief and the Quest for Meaning 249
21.4 Techniques for Reconstructing Meaning in Loss 251
21.5 Clinical Illustration of Therapy as Meaning Reconstruction 254
21.6 Overview of Efficacy of Meaning-Making Interventions 255
21.7 Service Development to Build a Programme 255
21.8 Conclusion 255
References 256
Index 259