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Section 12
Cognitive Intervention for Cancer Patients

Question 12 | Test | Table of Contents

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In the last section, we discussed time management techniques. In my practice, I implement six interventions that can help foster productive time management.  These six interventions are the daily to-do list, direct delegation, familial delegation, Avoiding the Supercaregiver Trap, research services and scheduling phone time. 

In this section, we will discuss compartmentalizing cancer thoughts.  Because obsessive thinking rarely solves any problems and it drains clients, this section offers strategies for avoiding obsessive thinking through compartmentalization. 

♦ Case Study: Robert
Robert, age 34, refers to himself as "a habitual obsessor."  Robert stated, "I can’t sleep at night because I toss and turn, going over and over my wife’s cancer in my head!  I ask myself, ‘How can I get more information?  Who can I call?  Why did the doctor say that!?  Why is my wife acting this way?  What is she not telling me?"  Robert was also distracted by the cancer during the daytime.  If he was out with others, he’d steer the conversation to the disease, and he wouldn’t listen when friends discussed other subjects.  Robert stated, "My mind is always wandering, always returning to my wife’s illness." 

♦ Cancer Thought Time
In order to help Robert begin functioning again, I felt that it would be productive for him to stop obsessing.  I stated, "Set aside specific times each to reflect on the disease, its problems, its challenges, and its meaning to you.  You can do this by writing about it, by talking to friends, and/or by meditating. Structuring this time will keep you from obsessing about the disease.  If you find yourself obsessing tell yourself, ‘No it is only 1:00 and my Cancer Thought time is at 4:30 on my drive home from work.  I can wait a couple more hours to think about this.’"

By setting aside time each day to focus on the disease, to give it his full, undivided attention, Robert learned how to compartmentalize his cancer thoughts.  At a later session, Robert stated, "Every time I obsessed about the disease, I stopped and told myself to save those thoughts for the time I had scheduled for reflection.  I chose the drives to and from work.  I visualize putting those thoughts in a box, knowing I could open it later." 

I responded, "It’s not always possible to set aside your emotions, but does this technique reduce the amount of time you spend worrying?"  Robert answered, "Yes.  When the drive times come, I give my full attention to the cancer and my thoughts and feelings about it.  Sometimes I call a friend and talk, releasing the emotions that way.  Sometimes I write in my journal, and sometimes I just take a long walk and reflect on our situation."

Initially clients like Robert may be hesitant to join a support group.  Might your client think he or she will become even more obsessed with the cancer than they already are?  As Robert stated, "Why should I go somewhere to talk about my problems for ninety minutes every week?  That seems awfully negative."  Yet before learning to compartmentalize his cancer thoughts, Robert was spending at least seventy percent of every day thinking about his problems.  

After a few months attending a support group, Robert stated, "I went from focusing on the cancer seventy percent of the day to probably twenty percent.  When I obsessed over it, I didn’t resolve anything, and I wasted precious time.  Now I talk about my issues once a week in a constructive manner during group.  I’m able to look at the cancer and the changes in my life and evaluate them in a way that helps me feel more in control of my life."

In this section, we discussed compartmentalizing cancer thoughts. Because obsessive thinking rarely solves any problems and it drains clients, this section offers strategies for avoiding obsessive thinking through compartmentalization. 

In the next section, we will discuss supporting the children.  This section includes four guidelines for helping your clients as parents dealing with children who are trying to cope with cancer in the family or of a friend or loved one.  The four guidelines for supporting children are preparing to tell the children, talking to children about cancer, evaluating reactions, and discussing cancer with multiple children.
Reviewed 2023  

Peer-Reviewed Journal Article References:
Brothers, B. M., Yang, H.-C., Strunk, D. R., & Andersen, B. L. (2011). Cancer patients with major depressive disorder: Testing a biobehavioral/cognitive behavior intervention. Journal of Consulting and Clinical Psychology, 79(2), 253–260. 

Desautels, C., Savard, J., Ivers, H., Savard, M.-H., & Caplette-Gingras, A. (2018). Treatment of depressive symptoms in patients with breast cancer: A randomized controlled trial comparing cognitive therapy and bright light therapy. Health Psychology, 37(1), 1–13.

Ellis, E. M., Ferrer, R. A., Taber, J. M., & Klein, W. M. P. (2018). Relationship of “don’t know” responses to cancer knowledge and belief questions with colorectal cancer screening behavior. Health Psychology, 37(4), 394–398.

Foley, E., Baillie, A., Huxter, M., Price, M., & Sinclair, E. (2010). Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 78(1), 72–79.

Gudenkauf, L. M., Antoni, M. H., Stagl, J. M., Lechner, S. C., Jutagir, D. R.,
Bouchard, L. C., Blomberg, B. B., Glück, S., Derhagopian, R. P., Giron, G. L., Avisar, E., Torres-Salichs, M. A., & Carver, C. S. (2015). Brief cognitive–behavioral and relaxation training interventions for breast cancer: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 83(4), 677–688. 

Poort, H., Müller, F., Bleijenberg, G., Verhagen, S. A. H. H. V. M., Verdam, M. G. E., Nieuwkerk, P. T., & Knoop, H. (2021). Condition or cognition? Mechanism of change in fatigue in a randomized controlled trial of graded exercise therapy or cognitive behavior therapy for severe fatigue in patients with advanced cancer. Journal of Consulting and Clinical Psychology, 89(9), 731–741.

QUESTION 12
What is one strategy for avoiding obsessive thinking? To select and enter your answer go to Test.


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