Cognition and the cancer experience - Clinical implications

OBJECTIVES: The authors demonstrate the application of cognitive therapy in oncology care by presenting a brief review of theory and relevant case stu dies. MATERIALS AND METHODS: In light of the life and death nature of the fears e voked by cancer, it is important for the oncology clinician to recognize th e role that cognition plays in patient responses to the diagnosis and treat ment of cancer. After presentation of a theory base that creatively links c ognition and the cancer experience, key cognitive concepts are defined and discussed. Case material illustrates the application of these concepts and how oncology clinicians fan use select interventions adapted from the brief mental health treatment modality of cognitive therapy to promote adjustmen t to cancer. RESULTS: Patient and family views about cancer have emotional and behaviora l consequences, influence ability to cope with diagnosis and treatment, and serve to focus clinical intervention. Cognitive interventions can help pat ients and families think about cancer in objective, adaptive ways. Focusing on perceptions and questions of meaning, clinicians can be effective using cognitive lines of questioning that expand patient stories and elicit beli efs about cause, control, and responsibility for their cancer. CONCLUSIONS: Cognitive interventions are brief and solution-focused interve ntions that acknowledge and build on generalist interviewing skills common to each discipline. As such, they are particularly useful in physical healt h settings where work is fast paced and clinicians are faced with the chall enge of dealing in a collaborative manner with patient and family coping re sponses as they apply to the medical problem and cafe plan.