Adjuvant Psychological Therapy: definition, characteristics and techniques

This type of psychotherapy is specifically designed for Cancer patients.

Suffering from a medical illness entails, in addition to the physical symptoms of the disease, a series of psychological and emotional alterations that cannot be ignored. psychological and emotional alterations that cannot be ignored..

Thus, the ideal is that the medical treatment is applied in combination with a psychological treatment focused on treating these alterations.

Today we will talk about a very specific therapy, Adjuvant Psychological Therapy, oriented to the treatment of cancer patients.. We will see what it consists of and the techniques it employs. In addition, we will know the responses of coping of the people before the diseases.

Basis of Adjuvant Psychological Therapy

The Adjuvant Psychological Therapy (APT) was developed by Moorey and Greer (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 on research conducted with breast cancer patients. It is a therapy that includes psychoeducation and considers the active collaboration of the patient as fundamental..

The intervention with Adjuvant Psychological Therapy is carried out in a series of 6 to 12 sessions of approximately one hour's duration. 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 the physical (vomiting, nausea,...) and associated psychological symptomatology. (anxiety, depression,...).
• To promote a fighting spirit in the face of the disease.
• To increase the feeling of personal control over one's own life.
• Develop effective coping strategies coping strategies.

Elements of APT

Adjuvant Psychological Therapy is based on the hypothesis that cancer-related psychological morbidity is determined, in addition to the actual consequences of the disease, by two fundamental variables:

• The personal meaning of the diseaseThe personal meaning of the disease: how the patient perceives the cancer and its implications.
• The patient's coping strategies 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 the emotional support he/she receives from them.

On the other hand, in the Adjuvant Psychological Therapy the quality of the emotional support received by the patient from his family, friends, doctors and nurses, which influences the two aforementioned 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 the disease and to try to recover from it.

Two authors, Watson (1988) and Greer (1989) list five categories of psychological responses to cancer. Let us look at them:

1. Fighting spirit

This is the adoption of an optimistic attitude towards the disease, being convinced of fighting against it, and to accept the diagnosis in its totality..

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 bursts abruptly and continuously into the patient's life, who cannot think about the future. of the patient, who cannot think of anything else. It is a dysfunctional mechanism that hinders coping with the disease and adherence to treatment.

3. Anxious Preoccupation

Here the anxiety is intense and persistent, and is often 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 worrisome way and the patient always associates it with the exacerbation of the cancer.

When the coping response is this, the patient usually turns to alternative treatments to treat his ailment.

4. Fatalism (Stoic Acceptance)

The patient adopts a fatalistic attitude of the situation; he accepts the disease with resignation, living it as something irremediable and that does not have cure. He/she does not adopt any measures to face the diseasesimply accepts the diagnosis and does not seek further information or resources.

5. Avoidance (Denial)

The person does not accept the diagnosis, denies it or even avoids using the word "cancer". The person may also recognize the diagnosis but deny or minimize its seriousness, as well as the negative symptoms it produces.

TPA Techniques

The psychological techniques included in Adjuvant Psychological Therapy are very varied. Some of them are:

• Cognitive techniques.Cognitive techniques: cognitive restructuring, recording of automatic thoughts,...
• Behavioral techniquesRelaxation, graded homework assignments,...
• Non-directive techniquesVentilation of feelings (helps to express repressed feelings and emotions).

When treating psychological disturbances associated with cancer, one should take into account, among other elements, the automatic negative thoughts (ANP) underlying the disease. The objective will be to identify and modify them, and this will be done through cognitive techniques.

Bibliographical 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. Psychological Bulletin, 36, 71-83.