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Psychological and Social Distress
Screening
Psychological and Social Assessment
Psychological and Social Therapies for Distress
Most patients experience some level of distress, however, only a small percentage receive help. Distress is an unpleasant emotional, psychological, social, or spiritual experience that interferes with the patient's ability to cope with cancer treatment. Patients may experience a range of feelings from normal sadness and fear to deep depression, anxiety, panic, or isolation. These feelings can interfere with a person's ability to relate to family, friends, coworkers, and others during the normal routines of daily living. This is called social distress.
Screening
Health care professionals may have patients complete questionnaires periodically to identify the need for referral to a mental health professional. Key times that distress may become disabling include the time of diagnosis, during cancer treatment, at the end of a long course of treatment, during remission, when the cancer returns, or when beginning palliative care. Patients who are experiencing mild distress may benefit from a referral to a self-help group. Patients who are experiencing moderate to severe distress may require a referral to a mental health professional such as a psychiatrist, psychologist, social worker, or pastoral counselor.
Psychological and Social Assessment
It is important that patients understand the benefits of talking with a mental health professional about their concerns and worries. A patient can expect the health professional to:
- Listen closely to his or her concerns.
- Show an interest in his or her experiences with cancer.
- Ask about his or her family, friends, and other persons who provide support.
- Ask how he or she has been adjusting to the cancer.
- Encourage him or her to continue using coping strategies that are successful.
- Suggest other coping strategies to address his or her concerns.
Patients will be encouraged to continue counseling or psychotherapy as needed.
Psychological and Social Therapies for Distress
Recent studies of psychological and social therapies have shown benefits for cancer patients. These therapies are defined as non- drug treatments offering psychological and educational support, such as:
These therapies may be combined in different ways for various lengths of time, in both individual and group formats. To date, these therapies have most commonly been studied in white, middle-to-higher income American women with breast cancer, though they are currently being studied in more patient groups. Cancer patients who receive such therapies show positive benefits compared to those who do not, including lower levels of depression, anxiety, and disease-related symptoms, as well as improved immune system functioning and health habits like exercise. The size of these benefits and how they affect patients' recovery will need more study.
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