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Interventions for Clients Coping with Cancer
Interventions for Clients Coping with Cancer - 10 CEUs

Section 9
Assessing Hopelessness in Cancer Patients

CEU Question 9 | CE Test | Table of Contents | Cancer
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

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On the last track we finished our three track discussion on reforming negative emotions.  We discussed controlling the intensity of the unpleasant emotion. 

On this track we will discuss hope.  I find that three factors can influence or result in hopelessness.  The three factors are myths about cancer, type of cancer, and intuition.  As you listen to this track, consider your client who is coping with cancer.  You might consider playing this track in a session for your client. 

How similar is your client’s level of hope to Jeremy’s?  Jeremy, age 29, felt he was too young to have cancer.  Jeremy stated, "It’s all over already!  I’m not even thirty and my life is over!"  Jeremy had colon cancer.

Elements of Hope and Hopelessness
After some supportive remarks to Jeremy, I shifted my reply to education mode.  I stated, "Hope consists of 3 elements
-- First, is a desire that an event will take place. 
-- Second is the possibility that the event will occur, and
-- third
is the belief that you will pleased if it does. 
Hopelessness, on the other hand, consists of only 2 elements: 
-- The first element of hopelessness is a desire that an event will take place. 
-- Second is the belief that no matter what you do, there is no possibility that the event will occur." 

Jeremy responded, "So hopelessness includes a feeling of helplessness."  Would you agree that, even though myths about cancer may lead clients to believe otherwise, in the great majority of cases it is unreasonable and unrealistic not to have hope? 

Debilitating Psychological Problems for Cancer Patients
Clearly, lack of hope, like any negative emotion, can be a serious matter for clients coping with cancer.  In fact, according to Dr. Harold Benjamin, the three most debilitating psychological problems cancer patients face are unwanted aloneness, loss of control, and hopelessness.  Would you agree that hopelessness can result in lethargy, listlessness, and passive acceptance of what is perceived as inevitable?  Why would a client fight for recovery if he or she has no hope?  Dr. Frank Henker, at an APA meeting, stated, "Whether we acknowledge the influence of hope or not, it’s real, and it may even determine the life or death outcome of the patient." 

3 Reasons for Hopelessness
How does your client rate his or her degree of hope for recovery?  If he or she is not sure, perhaps the client could ask someone close to them the following questions.  For example, Jeremy asked his friend Rob, "Have I been using words that indicate that I believe I am doomed?  Have I been acting as if there is no hope?  Does it appear that I am drawing away from those I care about and who care about me?  Do I appear more listless and lethargic than usual?"  On a scale of one to ten, Jeremy rated his degree of hope a 2. I stated, "There are several reasons for feelings of hopelessness."

Reason #1. Myths About Cancer
"The first reason for hopelessness is the myth that everyone with cancer dies because of the cancer."  Think of your Jeremy.  How might you disprove the myth that everyone with cancer dies from it?  In my practice, I tend to cite data published by the American Cancer Society in a bulletin titled Cancer Facts and Figures.  The literature indicates that 40 to 50 percent of all clients who have cancer recover from the illness.  It also shows that Americans with a history of cancer tend to have the same life expectancy as if they never had cancer.  I further stated to Jeremy, "In the 1930’s, one in five survived.  In the 1940’s, one in four, in the 60’s one in three.  And with medical technology today, one in two survive and fully recover from cancer."

Reason #2. Type of Cancer
Another myth and a second factor regarding hopelessness can be when a client ‘knows’ from one source or another that everyone who has his type of cancer dies from it.  Again, the American Cancer Society publishes information which indicates that there have been survivors of every known type of cancer.  I stated to Jeremy, "Why give up?  Even if it’s a hundred to one shot, you’ve still got a chance." 

Reason #3. Intuition
In addition to myths about cancer and type of cancer, a third cause for hopelessness is intuition.  At one session, Jeremy stated, "I feel it in my gut that my time is up."  Would you agree that this type of thinking is dangerous because it is based on nothing that can be refuted? 

To help Jeremy restore hope, we discussed techniques for avoiding stress.  We also discussed making plans for the future, which, for Jeremy, was productive.  Techniques for making plans for the future will be discussed on the next track.

On this track we discussed hope.  I find that three factors can influence or result in hopelessness.  The three factors are myths about cancer, type of cancer, and intuitive feelings. 

On the next track we will discuss making plans for the future as a means for restoring hope.  I find that there are three reasons for making plans for the future.  Three reasons for making plans for the future are it is fun.  Also, making plans for the future counteracts the giving up instruction clients may have unconsciously been giving the body. Third clients may be instructing the body to do everything it can to be around when that day comes, and there’s a guide that the body may comply with those instructions.

Peer-Reviewed Journal Article References:
Campos, R. C., Besser, A., Ferreira, R., & Blatt, S. J. (2012). Self-criticism, neediness, and distress among women undergoing treatment for breast cancer: A preliminary test of the moderating role of adjustment to illness. International Journal of Stress Management, 19(2), 151–174. 

Griesemer, I., Moore, E., Khan, C., Roche, M., Henderson, G., & Rini, C. (2019). Psychological adaptation to diagnostic genomic sequencing results: The role of hope fulfillment. Health Psychology, 38(6), 527–535.

Rosenfeld, B., Pessin, H., Lewis, C., Abbey, J., Olden, M., Sachs, E., Amakawa, L., Kolva, E., Brescia, R., & Breitbart, W. (2011). Assessing hopelessness in terminally ill cancer patients: Development of the Hopelessness Assessment in Illness Questionnaire. Psychological Assessment, 23(2), 325–336. 

Stanton, A. L., Wiley, J. F., Krull, J. L., Crespi, C. M., & Weihs, K. L. (2018). Cancer-related coping processes as predictors of depressive symptoms, trajectories, and episodes. Journal of Consulting and Clinical Psychology, 86(10), 820–830. 

Steffen, L. E., Vowles, K. E., Smith, B. W., Gan, G. N., & Edelman, M. J. (2018). Daily diary study of hope, stigma, and functioning in lung cancer patients. Health Psychology, 37(3), 218–227.

Online Continuing Education QUESTION 9
What are three factors which can influence or result in hopelessness? To select and enter your answer go to CE Test.
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