4.3.4 Psychotherapy and Structured Support
Some patients benefit from short-term psychotherapy or more complex
cognitive-behavioral interventions provided by a psychiatrist, clinical
psychologist, psychiatric nurse, or psychiatric social worker. Short-term
supportive psychotherapy based on a crisis intervention model can provide
emotional support, continuity, and information while helping the patient adapt
to the crisis. The therapist emphasizes the patient's past strengths, supports
the patient's use of previously successful coping strategies, and teaches new
coping skills. Studies have shown that patients with cancer who receive active,
structured psychological support report less pain and live longer (Fawzy,
Cousins, Fawzy, et al., 1990; Spiegel and Bloom, 1983; Spiegel, Bloom, Kraemer,
et al., 1989). Psychotherapy should be offered to patients whose pain is
particularly difficult to manage (e.g., substance abusers), those who develop
symptoms of clinical depression or another adjustment disorder, and those with
a history of psychiatric illness.
TENS
Acupuncture
Relaxation and Imagery
Distraction and Reframing
Hypnosis
Peer Support Groups
Pastoral Counseling
Patients with Psychiatric Problems Associated with Cancer Pain
Index