Treating Fear of Cancer Recurrence with Group Cognitive-Behavioural Therapy: A Step-by-Step Guide

Description

Cancer is the leading cause of death in the United States. The improvement of screening procedures and treatments have led to higher survival rates, and consequently to an increased number of individuals who fear that their cancer might come back. Fear of cancer recurrence (FCR) is defined as the fear, worry, or concern that cancer may come back or progress. FCR has been found to be the number one unmet need of cancer survivors. High levels of FCR are associated with greater psychological distress, impaired functioning, decreased quality of life, and increased medical consultations, psychotropic usage and health-care costs. It is therefore crucial to offer these patients an appropriate and effective treatment. The books first propose a theoretical model of FCR that identifies the five main targets of intervention in this program: 1) cognitive interpretation; 2) behavioural avoidance; 3) cognitive avoidance; 4) reassurance and control seeking; 5) intolerance of uncertainty. Then, each target is discussed and specific cognitive-behavioural therapy strategies are suggested that focus on each of them based on the best available empirical evidence for the treatment of anxiety disorders (e.g., generalized anxiety disorder) and cancer-related anxiety. This book will be of interest to clinicians working with cancer patients such as psychologists and other health care providers as well as cancer patients and survivors. Graduate students in clinical health psychology, and connecting disciplines such as psycho-oncology, psychiatry, nursing, social work, rehabilitation, spiritual care, and sexology might also find this text of value. Acknowledgments Contents About the Authors Part I: Psychotherapy Group on Fear of Cancer Recurrence: Therapist’s Manual 1: Session No. 1 1.1 Introduction 1.1.1 Slide #1: Fear of Cancer Recurrence 1.1.2 Slide #2: Psychotherapy Group on Fear of Cancer Recurrence 1.1.3 Slide #3: Warning 1.2 Content of the Sessions 1.2.1 Slide #4: Content of the Sessions 1.2.2 Slide #5: Session No. 1 1.3 Information on Fear of Cancer Recurrence 1.3.1 Slide #6: Fear of Cancer Recurrence 1.3.2 Slide #7: The Vicious Circle of Fear of Recurrence 1.4 Beliefs About the Influence of Psychological Factors on Cancer 1.4.1 Slide #8: The Vicious Circle of Fear of Recurrence 1.4.2 Slide #9: The Power of Thought 1.4.3 Slide #10: Influence of Psychological Factors on Cancer 1.4.4 Slide #11: Popular Beliefs 1.4.5 Slide #12: Clinical Cases vs. Scientific Research 1.5 Stress = Cancer? 1.5.1 Slide #13: Stress → Cancer? 1.5.2 Slide #14: Multifactorial Model of Cancer 1.6 Positive Thoughts = Cure? 1.6.1 Slide #15: Mental Attitude and Cancer Survival – Study 1 1.6.2 Slide #16: Mental Attitude and Cancer Survival – Study 2 1.6.3 Slide #17: Why Is It Important to Let Go of These Beliefs? 1.6.4 Slide #18: Summary 1.7 The Cognitive Model of Emotions 1.7.1 Slide #19: Cancer: A Distressing Experience 1.7.2 Slide #20: Cognitive Model of Emotions (Beck) 1.8 The Vicious Circle of the Tyranny of Positive Thinking: The Case of Melissa 1.8.1 Slides #21–22: The Case of Melissa 1.8.2 Slide #23: The Case of Melissa (Continued) 1.8.3 Slide #24: The Tyranny of Positive Thinking 1.8.4 Slide #25: Negative Thoughts vs. Positive Thoughts 1.8.5 Slide #26: Effects of Positive Thinking 1.9 What Does Research Say About the Effects of Positive Thinking? 1.9.1 Slide #27: Effects of Optimism 1.9.2 Slide #28: Fighting Cancer? 1.10 The Benefits of Realistic Thinking 1.10.1 Slide #29: Dark Glasses vs. Rose-Coloured Glasses 1.10.2 Slide #30: Is There an Alternative? 1.10.3 Slide #31: Realistic Thoughts or Clear Glasses 1.10.4 Slide #32: What Is Realistic Thinking? 1.10.5 Slides #33–34: The Case of Mary 1.10.6 Slide #35: Mary and Realistic Thoughts 1.10.7 Slide #36: Benefits of Realistic Thinking 1.10.8 Slides #37–38: The Case of Louise 1.10.9 Slide #39: Cancer and Realistic Thoughts 1.10.10 Slide #40: Do You Need to Change Your Way of Seeing Things? 1.11 Cognitive-Behavioural Therapy 1.11.1 Slide #41: Cognitive-Behavioural Therapy 1.12 Recognizing Negative Thoughts 1.12.1 Slide #42: Characteristics of Negative Thoughts 1.13 Thought Identification Exercise 1.13.1 Slide #43: Identification of Negative Thoughts 1.13.2 Slide #44: Exercise to Do at Home 1.14 Slide #45: End of Session Discussion 1.15 Slide #46: Tools in Brief References 2: Session No. 2 2.1 Session Agenda 2.1.1 Slide #3: Session No. 2 2.2 Review of the Previous Session 2.3 Review of Last Week’s Exercise 2.3.1 Slide #4: Review of the Thought Identification Exercise 2.4 Fear of Cancer Recurrence Model 2.4.1 Slide #5: The Vicious Circle of Fear of Recurrence 2.5 Cognitive Restructuring 2.5.1 Slide #6: Cognitive Restructuring Grid 2.5.2 Slide #7: The Case of Elise 2.5.3 Slide #8: Fear of Recurrence 2.5.4 Slide #9: The Case of Elise 2.5.5 Slide #10: Questioning Your Thoughts 2.5.6 Slide #11: The Case of Elise 2.5.7 Slide #12: Recurrence ≠ Death 2.6 Interpreting Physical Symptoms 2.6.1 Slide #13: Interpreting Physical Symptoms Realistically 2.6.2 Slide #14: Interpreting Physical Symptoms Realistically (NILP) 2.7 Information-Seeking Profiles 2.7.1 Slide #15: The Importance of Seeking the Right Information 2.8 Being Well Informed 2.8.1 Slide #16: Being Well Informed 2.9 Interpreting Probabilities and Statistics 2.9.1 Slide #17: Interpreting Probabilities 2.9.2 Slide #18: Interpreting Probabilities 2.9.3 Slide #19: Interpreting Probabilities 2.9.4 Slide #20: Interpreting Probabilities 2.9.5 Slide #17: Interpreting Probabilities (Go Back to a Previous Slide) 2.10 Cognitive Restructuring Exercise 2.10.1 Slide #21: Exercise to Do at Home 2.10.2 Slides # 22-23: Cognitive Restructuring Grid and Questionning your Thoughts 2.11 Slide #24: End of Session Discussion 2.12 Slide #25: Tools in Brief References Untitled Untitled 3: Session No. 3 3.1 Session Agenda 3.1.1 Slide #3: Session No. 3 3.2 Review of the Previous Session 3.3 Review of Last Week’s Exercise 3.3.1 Slide #4: A Look Back on Cognitive Restructuring 3.3.2 Slide #5: Cognitive Restructuring Grid 3.3.3 Slide #6: Questioning Your Thoughts 3.4 Intolerance of Uncertainty 3.4.1 Slide #7: The Vicious Circle of Fear of Recurrence 3.4.2 Slide #8: Intolerance of Uncertainty 3.4.3 Slide #9: What Do You Think of the Following Statements? 3.4.4 Slide #10: Learning to Tolerate Uncertainty 3.5 Erroneous Beliefs about Worry 3.5.1 Slide #11: The Usefulness and Impact of Worrying 3.5.2 Slide #12: Behavioural Experiment 3.5.3 Slide #13: Summary 3.6 Behavioural Avoidance 3.6.1 Slide #14: The Vicious Circle of Fear of Recurrence 3.6.2 Slide #15: Avoidance 3.6.3 Slide #16: Avoidance and Habituation Curves 3.6.4 Slide #17: Behavioural Exposure Rules 3.6.5 Slide #18: Avoidance and Cancer 3.7 Behavioural Exposure Exercise 3.7.1 Slide #19: The Importance of Facing Your Fears 3.7.2 Slide #20: Exercise to Do at Home 3.7.3 Slide #21: Behavioural Exposure 3.8 End of Session Discussion 3.8.1 Slide #22: End of Session Discussion 3.9 Slide #23: Tools in Brief 4: Session No. 4 4.1 Session Agenda 4.1.1 Slide #3: Session No. 4 4.2 Review of the Previous Session 4.3 Review of Last Week’s Exercise 4.3.1 Slide #4: Review of the Behavioural Exposure Exercise 4.3.2 Slide #5: The Vicious Circle of Fear of Recurrence 4.4 Cognitive Avoidance 4.4.1 Slide #6: Cognitive Avoidance - The Camel Exercise 4.4.2 Slide #7: Cognitive Avoidance 4.4.3 Slide #8: The Importance of Facing Your Thoughts 4.5 Strategies to Counter Cognitive Avoidance 4.5.1 Slide #9: Cognitive Restructuring 4.5.2 Slide #10: Planned “Worry Time” 4.5.3 Slide #11: Tolerating Negative Thoughts and Emotions 4.5.4 Slide #12: Cognitive Exposure 4.5.5 Slide #13: Avoidance and Habituation Curves 4.6 Seeking Reassurance 4.6.1 Slides #14–15: The Vicious Circle of Fear of Recurrence and Reassurance Seeking: A Form of Avoidance 4.6.2 Slide #16: Reassurance Behaviour Examples 4.6.3 Slide #17: Reassurance: Yes, But to What Extent? 4.7 Seeking Control 4.7.1 Slide #18: Seeking Control 4.7.2 Slide #19: Seeking Control 4.8 What If Cancer Comes Back? 4.8.1 Slide #20: What If Cancer Comes Back? 4.8.2 Slide #21: Recurrence ≠ Death 4.9 Redefining Life Goals 4.9.1 Slide #22: The Importance of Life Goals 4.9.2 Slides #23–24: The Case of Alfred 4.9.3 Slide #25: Redefining Life Goals (Step 1) 4.9.4 Slide #26: Redefining Life Goals (Step 2) 4.9.5 Slide #27: Avenues for Reflection 4.10 Slide #28: End of Session Discussion 4.11 Slide #29: Tools in Brief 4.12 General Review of the Psychotherapy Group 4.12.1 Slide #30: Conclusion Reference Untitled Part II: Psychotherapy Group on Fear of Cancer Recurrence: Participant’s Manual 5: Session No. 1 5.1 What Is Fear of Recurrence? 5.1.1 Fear of Recurrence: Is It Normal or Not? 5.1.2 Understanding the Vicious Circle of Fear of Recurrence 5.2 Can Thoughts Influence Cancer? 5.2.1 Beliefs About the Influence of Psychological Factors on Cancer 5.2.2 Does Stress Cause Cancer? 5.2.3 Does Thought Have the Power to Cure Cancer? 5.2.4 Can Positive Thinking Help You Cope with Cancer? 5.3 The Cognitive Model of Emotions 5.3.1 Cancer: A Distressing Experience 5.3.2 The Cognitive Model and Adjustment to Cancer 5.4 The Benefits of Realistic Thinking 5.4.1 The Tyranny of Positive Thinking 5.4.2 Fighting Cancer? 5.4.3 Dark, Rose-Coloured, or Clear Glasses? 5.4.4 Realistic Thinking and Cancer References 6: Session No. 2 6.1 Cognitive Restructuring 6.1.1 Cognitive Restructuring 6.1.2 Cognitive Restructuring and Fear of Cancer Recurrence 6.2 Interpreting Physical Symptoms Realistically 6.2.1 Seeking the Right Information on Your Condition 6.3 Being Well Informed 6.4 Interpreting Probabilities and Statistics Reference Untitled 7: Session No. 3 7.1 Intolerance of Uncertainty 7.2 Learning to Tolerate Uncertainty 7.3 Erroneous Beliefs about Worry 7.4 The Importance of Facing Your Fears 7.4.1 Avoidance and Habituation 7.5 Behavioural Avoidance and Cancer 7.6 Behavioural Exposure 8: Session No. 4 8.1 Cognitive Avoidance 8.2 Facing Your Thoughts 8.2.1 Cognitive Restructuring 8.2.2 Planned “Worry Time” 8.2.3 Tolerating Unpleasant Thoughts and Emotions 8.2.4 Cognitive Exposure 8.3 Seeking Reassurance 8.4 Seeking Control 8.5 What If Cancer Comes Back? 8.6 Redefining Life Goals 8.7 Conclusion References Appendix Exercise Exercise Exercise Exercise Index