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Ask the Mental Health Expert Archives 2001-2004

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Cancer Patient

Q. I'm a nursing student in the UK. I am interested in working with cancer patients, that is, supporting them with their psychological needs. How do you best facilitate communication when a cancer patient is in distress? What techniques would you recommend in helping them deal with serious illness?

A. It's hard to provide a short course on supportive work with cancer patients in the space of a few paragraphs-and, of course, this is something that you must learn in the context of your own professional development and supervision. I think the first thing to keep in mind is that every patient has different emotional defenses, and different emotional needs. Thus, there are some patients with cancer or other serious illness who do not want to spill their guts, but instead, crave the normalcy of chatting about sports.

Others may want to talk in very intimate terms about their deepest fears regarding death and dying. Some patients do not want to know each and every truth that faces them, while others actively seek out all the details of their illness. It is a mistake to assume that one size fits all when it comes to working with seriously ill individuals.

I would suggest you read a number of articles in the professional literature by Dr. Jimmie Holland, at memorial Sloan-Kettering Cancer Center in New York; e.g., Massie and Holland, J Clin Psychiatry, July 1990, supplement 6, ppl. 12-17 ("Depression and the cancer patient"). Then, you might want to see the book, "Helping Cancer Patients Cope: A Problem-Solving Approach", by Arthur M Nezu (editor) et al (1998).

I have not read the book, but at least one professional review was very favorable. The book includes case studies, transcripts from sessions, and "how to" sections. Good luck with this challenging work!

March 2001

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