Academic journal article Health and Social Work

A Support Group Intervention to Facilitate Young Adults' Adjustment to Cancer

Academic journal article Health and Social Work

A Support Group Intervention to Facilitate Young Adults' Adjustment to Cancer

Article excerpt

Psychological disturbance in response to the diagnosis of cancer is well documented (Weisman, Worden, & Sobel, 1980). There is considerable evidence that younger cancer patients suffer greater psychological distress (Ganz, Schag, & Heinrich, 1985; Roberts, Rossetti, Cone, & Cavanagh, 1992; Vinokur, Threatt, Vinokur-Kaplan, & Satariano, 1990). Cella and Tross (1986) studied young adults (average age 31.1 years) who were survivors of Hodgkin's disease and compared them to age-matched controls. The cancer survivors were found to be more anxious, to have a poorer body image, and to experience marked fears of recurrence. Many reported that their careers had suffered. Twenty percent had sexual problems, and many had become infertile as a result of treatments. The young cancer survivors were also more socially isolated and had fewer intimate relationships than the age-matched controls.

Both research studies and clinical observations point to the greater stress and disruption that cancer imposes on young adults. Cancer treatments create life changes that disrupt the normal psychological and social developmental tasks of young adulthood. Gould (1972) and Levinson and Gooden (1985) cited these developmental tasks as including establishing independence from parents, getting started in a career, finding a mate, and becoming a parent.

Cancer diagnosis and treatment can interfere with developmental tasks in multiple ways. Physical illness may make it necessary for the young adult cancer patient to return to the parental home for care. Treatment expenses and possible loss of employment may make the young person financially dependent on parents as well. Education or career plans may need to be postponed. The young adult who has married confronts somewhat different problems. He or she may fear becoming less physically attractive to or a burden on the spouse. The threat of infertility resulting from cancer treatments is a source of concern for patients who have not completed plans for a family.

The young cancer patient is confronted with an awareness of mortality, a developmental issue not normally addressed until the sixth decade of life or later. Even patients with a good prognosis experience considerable psychological distress (Moos & Tsu, 1977). This suffering can create resentment or grief over the possible loss of the opportunity to fulfill one's dreams. Further, young adult cancer patients may worry about poor health or dying, which alienates them from healthy peers, who usually avoid thoughts or discussions of death.

In recent years psychosocial ontology researchers have begun to focus their efforts on designing and evaluating psychological interventions to ameliorate the stress of cancer and to assist survivors in coping with the disease. Most intervention research has focused on techniques useful to patients with particular types of cancer, such as breast cancer or melanoma, or in specific stages of illness, such as newly diagnosed patients or those experiencing recurrence of disease. Social workers caring for young adults with cancer report that these patients feel that they have little in common with older patients and that their concerns are specific to being young and struggling with the consequences of the physical and psychosocial sequelae of cancer.

A survey of young adult cancer survivors regarding life changes and problems they experienced following their cancer diagnosis and treatment revealed six areas of concern: (1) anxiety about health, (2) loss of physical well-being, (3) worry about children, (4) problems in relationships, (5) financial and vocational concerns, and (6) feelings of unattractivenes (Roberts et al., in press). Based on these survey results, a six-week, professionally led support group intervention was designed to address the unique concerns of young adults with cancer. The effectiveness of this intervention in reducing psychological distress and enhancing the coping skills and quality of life of these patients was evaluated. …

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