Breast Cancer

By Lesley Fallowfield; Andrew Clark | Go to book overview

Chapter six

Psychological interventions

The previous chapters in this book have described the myriad of emotional, social, and physical difficulties experienced by women at different stages of their disease. It should be obvious that any therapeutic approach that dismisses or ignores the substantial impact that psychological factors have on good outcome and long-term adjustment is both poor medicine and poor science. The breast-care specialist nurse or oncology counsellor plays a vital role in the rehabilitation of women with breast cancer and a clear need exists for counselling support of the patient and her family, especially during terminal illness. The clinical psychologist may also help those women who develop such things as phobic reactions to their prosthesis, social and sexual avoidance, and obsessional checking of their bodies for signs of disease recurrence. Those women unfortunate enough to experience classically conditioned responses to chemotherapy, especially the distressing anticipatory nausea and vomiting, may find relief following desensitization and/or relaxation and stress management training. Finally, the liaison psychiatrist may supplement these interventions with psychotherapy and pharmacological treatment in the form of anxiolytics or anti-depressants for those patients with serious unremitting anxiety and/or depression.

In this chapter I shall discuss some of the specific counselling needs of women at different stages of breast cancer; I shall look briefly at some of the evidence for the efficacy of counselling and other interventions and provide illustrative examples of counselling from the case histories of women with breast cancer, whom I have myself counselled or interviewed about their counselling experiences.

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