Acute cancer cognitive therapy Journal Article


Authors: Levin, T. T.; Applebaum, A. J.
Article Title: Acute cancer cognitive therapy
Abstract: The utility of cognitive therapy (CT) for ambulatory cancer patients is clear but the acute cancer setting significantly shapes the therapeutic interaction, parameters, and delivery of CT. In this article, we describe how to apply CT to acute cancer settings, focusing on how this approach differs from traditionally taught, ambulatory CT. We highlight the importance of a tailored history and formulation, how the cognitive model is applied within an acute cancer context to promote coping and adaptation. Reframing must consider the "grain of truth" to many so-called distorted cognitions, such as "cancer means death." Fear of recurrence is an example of a common reframing challenge. Another is the "tyranny of positive thinking." Here there is avoidance of considering negative outcomes such as death; patients are told to "think positive," leaving them alone at a time of life-threatening crisis. Instead, acute cancer CT utilizes a stance of realistic optimism. Empathy plays a vital role in turning off the bracing reaction to threat and facilitating problem-solving. Successfully combining CT with medications is integral to this model. We also discuss how CT can be applied to discussing prognosis, the desire for hastened death and suicidality, as well as death and dying in general. Because of the ubiquitous nature of cancer, most cognitive therapists will encounter patients with cancer in their practices. Acute cancer CT is a skill set that should be widely taught to cognitive therapists and flagged as a priority for academic programs and professional organizations.
Keywords: cancer chemotherapy; cancer recurrence; cancer patient; confusion; patient care; narcotic analgesic agent; death; empathy; medical society; antidepressant agent; neuroleptic agent; cognitive therapy; outpatient; coping behavior; cognitive defect; problem solving; fear; neurological complication; dying; education program; benzodiazepine; psychostimulant agent; death and dying; psychopharmacotherapy; medical history; suicidal behavior; optimism; coping; adaptation; hypomania; dronabinol; cancer prognosis; hypnotic agent; life threat; prognosis; human; article; acute cancer cognitive therapy; combined ct-pharmacotherapy; grain of truth; psychotherapist
Journal Title: Cognitive and Behavioral Practice
Volume: 21
Issue: 4
ISSN: 1077-7229
Publisher: Elsevier Inc.  
Date Published: 2014-11-01
Start Page: 404
End Page: 415
Language: English
DOI: 10.1016/j.cbpra.2014.03.003
PROVIDER: scopus
PMCID: PMC6291221
PUBMED: 30555220
DOI/URL:
Notes: Export Date: 1 December 2014 -- Source: Scopus
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  1. Tomer T Levin
    62 Levin
  2. Allison Joyce Applebaum
    191 Applebaum