Services to Help Cope with Emotions
A wide variety of mental health therapies have been developed to treat emotional distress and mental health problems.1 Although it was beyond the scope of this report to examine the evidence in support of all types of services to address all manifestations of emotional distress and mental health problems in individuals with cancer,2 the discussion below reviews peer support programs selected because of their widespread use and availability, as well as counseling/psychotherapy and medications that address depression and anxiety—among the most common mental health conditions affecting individuals diagnosed with cancer.
Peer support programs Peer support is defined as a relationship in which people with the same condition provide emotional support to each other and share knowledge about dealing effectively with that condition. Vicariously experiencing the successes of others similar to oneself is a primary pathway to building one’s own self-efficacy (Bandura, 1997). Self-efficacy is viewed as a key predictor of how effectively individuals can motivate themselves and persevere in the face of adversity, how much effort they will make in pursuing a course of action, and what their emotional reactions to the course of events will be. Self-efficacy is also an important determinant of how extensively knowledge and skills are obtained (Pajares, 2002), and there is evidence that it is a critical factor in an individual’s successful self-management of a range of chronic illnesses (Lorig et al., 2001; Lorig and Holman, 2003).
Peer support programs can provide one-on-one support (as in the American Cancer Society’s Reach to Recovery program) or support from groups. Peer support groups (also called self or mutual support groups) have been studied most often. Emotional support is a primary component of peer support groups (Weis, 2003; Ussher et al., 2006). These groups also typically provide information and education, sharing of coping skills, acceptance by others in similar situations, a sense of normalcy, and diminished social isolation (Barlow et al., 2000; Campbell et al., 2004). Many of these supports are the same as those provided by beneficial informal social networks described in Chapter 2, which have been found to reduce
1In child and adolescent therapy alone, for example, it is conservatively estimated that, even if one omits various combinations of treatments and variants of treatments that are not substantially different, there are more than 550 psychotherapies in use (Kazdin, 2000).
2For example, this report does not address the unique clinical treatment issues of individuals with mental illnesses such as schizophrenia and psychotic disorders. However, the access to specialized mental health services described in Chapter 6 pertains to cancer patients with all types of mental health problems and illness, not just those described in this chapter. The reader is directed to a recent IOM report, Improving the Quality of Health Care for Mental and Substance-Use Conditions (IOM, 2006), which addresses approaches to coordinating mental health care with other medical care for all types of mental health conditions.