Adjuvant Psychological Therapy: definition, characteristics and techniques
Suffering from a medical illness entails, in addition to the physical symptoms inherent in the illness, a series of psychological and emotional alterations that cannot be ignored .
Thus, ideally, medical treatment should be applied in combination with psychological treatment aimed at treating such disorders.
Today we will talk about a very concrete therapy, the Adjuvant Psychological Therapy, oriented to the treatment of patients with cancer . We are going to see what it consists of and the techniques it uses. In addition, we will know the responses of people to face up to illnesses.
Basics of Adjuvant Psychological Therapy
Adjuvant Psychological Therapy (APT) was developed by Moorey and Gree r (1989) and is intended for cancer patients. Its efficacy has been demonstrated in several investigations, providing short and long term benefits.
TPA is based on Beck’s Cognitive Therapy (Beck, 1976) and research with breast cancer patients. It is a therapy that includes psychoeducation and considers the active collaboration of the patient to be fundamental .
The intervention with the Adjuvant Psychological Therapy is carried out in a series of 6 to 12 sessions of one hour duration (approximately). The essential objective of the therapy is to increase the patient’s well-being and survival time through the achievement of more specific goals. Some of them are:
- Reducing physical symptoms (vomiting, nausea,…) and associated psychological symptoms (anxiety, depression,…).
- Promote a spirit of fighting disease.
- Increase the sense of personal control over one’s life.
- Develop effective coping strategies .
Elements of the TPA
Adjuvant Psychological Therapy is based on the hypothesis that psychological morbidity related to cancer is determined, in addition to the actual consequences of the disease, by two fundamental variables:
- The personal meaning of the disease : how the patient perceives the cancer and the implications that this entails.
- The patient’s coping strategies : what the patient thinks and does to reduce the threat posed by the disease.
These two variables are analyzed in therapy, delving into the person’s personal relationships and the quality of emotional support they receive from them.
On the other hand, in Adjuvant Psychological Therapy the quality of the emotional support that the patient receives from family, friends, doctors and nurses is analysed, which influences the two commented variables of the therapy.
Coping Responses
The patient’s coping responses are those psychological, social, and emotional mechanisms that the person uses to cope with and attempt recovery from the illness.
Two authors, Watson (1988) and Greer (1989), have listed five categories of psychological responses to cancer. Let’s see them:
1. Spirit of struggle
It is about adopting an optimistic attitude towards the disease, being convinced to fight against it and accepting the diagnosis in its entirety .
It is characteristic of people who approach life’s obstacles as challenges rather than difficulties.
2. Helplessness/hopelessness
It is the adoption of a defeatist and pessimistic attitude towards the disease. The person has no hope of recovery.
It implies that the cancer suddenly and continuously breaks into the life of the patient, who cannot think of anything else. It is a dysfunctional mechanism that makes it difficult to cope with the disease and to adhere to treatment.
3. Anxious concern
Here the anxiety is intense and persistent, and is often accompanied by depressive symptoms . The patient actively seeks information about the cancer but interprets it in a pessimistic and negative way. Every symptom of the disease is experienced in a highly worrying way and the patient always associates it with the exacerbation of the cancer.
When the coping response is this, the patient often turns to alternative treatments to address their condition.
4. Fatalism (Stoic acceptance)
The patient adopts a fatalistic attitude to the situation; he accepts the illness with resignation, living it as something irremediable and without a cure. He does not adopt any measures to face the illness , he simply accepts the diagnosis and does not look for more information or resources.
5. Avoidance (Denial)
The person does not accept the diagnosis, denies it or even avoids using the word “cancer”. He or she may also recognize the diagnosis but deny or minimize its severity and the negative symptoms it causes.
TPA techniques
The psychological techniques included in Adjuvant Psychological Therapy are very varied. Some of them are:
- Cognitive techniques : cognitive restructuring, automatic thought recording,…
- Behavioral techniques : relaxation, assignment of graduated tasks,…
- Non-directive techniques : ventilation of feelings (helps to express repressed feelings and emotions)
When treating psychological disorders associated with cancer, account should be taken, among other things, of the automatic negative thoughts (ANP) underlying the disease. The aim will be to identify and modify them, and this will be done using cognitive techniques.
Bibliographic references:
- Watson,M.-Greer,S.-Young,J, et al.(1988): Development of a questionnaire measure of adjustment to cancer. The MAC scale. Psychological Medicine, 18, 203-209.
- Greer,S.-Moorey,S.-Watson,M.(1989): Patient’s adjustment to cancer. The Mental Adjustment to Cancer (MAC scale vs. clinical rating. Journal of Psychosomatic Research, 33, 373-377.
- Greer, S. (1992). Adjuvant Psychological Therapy for women with breast cancer. Psychology Bulletin, 36, 71-83.