Last Updated on November 1, 2020 by Marilyn Walker
Cognitive Behavioral Therapy (CTB) could be helpful in so many ways. Helping to fight to cancer-related rsychological disorders is one of them.
Cancer is one of the most deadliest diseases. Therefore, it is very common for people diagnosed with cancer to feel anxious because of the treatment they will receive. It has been reported in many studies that psychosocial problems are present in most of the patients at every stage of the disease, and that these problems lead to various psychiatric disorders such as adjustment disorder, anxiety disorders and depression due to both cancer and side effects of treatment.
CBT, which is one of the psychosocial development for cancer patients. It focuses on recognition and improvement, changing incompatible thoughts and behaviors, and improving the quality of life. It is used to make the patient feel better in daily life during cancer treatment.
However, the objectives of the CBT are to increase the sense of control to raise morale and to develop coping strategies that are appropriate to the solution of problems. CBT is for both individual and group therapy, and especially for cancer patients.
There are different protocols according to the type of cancer and emotional disorders such as anxiety problems, depression, and adaptation problems that occur after the stage.
The effectiveness of CBT in psychiatric disorders in cancer patients has been evaluated in many studies and its benefits have been indicated. In addition, it’s effective in reducing treatment side effects such as fatigue and insomnia. Indeed, in recent years researches revealed that , one third of the psychosocial interventions on cancer patients were primarily cognitive-behavioral therapies. The dissemination and implementation of such studies will contribute to the improvement of the quality of life of cancer patients.
Depression is a serious health problem that adversely affects the quality of life of cancer patients. They’re at high risk for persistent depressive symptoms and disorders; compared to the general population. It is important for doctors to know whether it is a normal cancer-related sadness or a symptom of clinically significant depressive disorder.
Diagnosing and treating depressive symptoms is so important
It is not easy to distinguish whether it is a symptom of depressive disorder or a normal sadness. And cancer patients usually ignore depression. Because many symptoms of depression, such as fatigue, weight loss, appetite, or sleep disturbance, can also mirror the physiological symptoms of cancer and its treatment and may prevent the diagnosis of depression.
Stiefel reported the effectiveness of psychological interventions in depressive cancer patientsin his study . Psychotherapies (especially CBT) are effective in improving depressive symptoms in cancer patients in several small-scale studies. Cognitive behavioral approach decreases the level of depression and anxiety in cancer patients; due to most recent studies the effectiveness of CBT.
Cognitive-behavioral techniques are very useful and effective for the treatment of depression in cancer patients. In a meta-analysis study by Schineider et al., CBT is one of the most effective treatment methods for depression in cancer patients.
Anxiety disorders include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, specific phobias and post-traumatic stress disorder. Some researchers have reported that anxiety is a normal response to cancer diagnosis. And threats such as loss of body function, changes in appearance, family disintegration, death, etc. In patients with cancer, anxiety may first appear at the time of a life-threatening diagnosis.Physical reactions may include sweating, dyspnea, dizziness, and tachycardia. BDT is one of the most effective psychotherapy approaches in the treatment of anxiety disorder.
DSM-IV defines- adjustment disorder, as an identifiable stress (for example cancer diagnosis) as a reaction. However, this response is less severe than ‘identifiable emotional disorder, such as major depression or generalized anxiety disorder. In addition, adjustment disorder leads to impairment of social and occupational functioning and psychiatric classification has an important place.
Suicidal behavior and length of hospital stay were longer in patients with adjustment disorder. For these reasons, it is important to recognize the adjustment disorder early in cancer patients and start treatment as soon as possible. Cognitive Behavioral Therapy is one of the most common psychological intervention approaches in cancer adaptation problem.
CBT encourages patients to identify excessive negative or irrational comments (cognitions) that patients have about their illness and life states, analyzes how these thoughts turn into dysfunctional behaviors, and then the therapist helps them gain more reasonable cognitions and more functional behaviors . It may also include training in relaxation techniques to manage stress. CBT also hasa positive effect on emotional and functional adaptation to cancer.
Insomnia is the most common sleep disorder in cancer patients. Cancer-related insomnia can be classified as secondary or accompanying insomnia because it is related to a medical condition. Fleming stated that the patients were at high risk for insomnia because of the emotional consequences of cancer diagnosis. Babson reported the existence of insomnia up to 5 years after cancer treatment.
Cognitive Behavioral Therapy for Insomnia in Cancer Patients has been developed in recent years. This program is based on the work of Morin includes 8 weeks to cancer patients and survivors ranging from 6-10 people for 90 minutes. It is a special form of CBT and at its core is to identify thoughts that cause insomnia and to change behaviors. CBT is very promising in the treatment of cancer-related fatigue and insomnia. The most commonly used strategies within the CBT program are stimulus control, sleep restraint and relaxation therapies, paradoxical intent, sleep hygiene and cognitive restructuring.
Also the reports say cancer patients with sleep disorders had significantly higher fatigue levels than patients without sleep disorders. Interestingly, this study states that fatigue was not an important determinant in patients with sleep disorder and depression. This shows that the nature of cancer-related fatigue is different from its relationship to depression. It is an effective treatment to manage symptoms of fatigue in patients undergoing medical treatments for CB cancer. Gielissen evaluated the effectiveness of CBT in post-treatment fatigue levels of patients surviving cancer and showed that the fatigue level of the group receiving CBT was significantly lower than the control group.
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