The Effectiveness of CBT in Cancer-Related Psychological Disorders

Cognitive Behavioral Therapy (CTB) could be helpful in so many ways. Helping to fight to cancer-related psychological disorders is one of them.

Cognitive-behavioral therapy (CBT) is a form of psychotherapy that aims to improve mental health by identifying and changing inaccurate or negative thinking and behavior. CBT has been shown effective in treating psychological disorders like depression, anxiety, eating disorders, obsessive-compulsive disorder (OCD), bipolar disorder, schizophrenia and posttraumatic stress disorder (PTSD).

An increasingly important application for CBT is its use in cancer patients who suffer from psychological symptoms due to their diagnoses. This article will discuss the effectiveness of CBT in treating cancer-related psychological symptoms such as depression and anxiety.

Cancer is one of the deadliest diseases. Therefore, it is very common for people diagnosed with cancer to feel anxious because of the treatment they will receive. It has been reported in many studies that psychosocial problems are present in most of the patients at every stage of the disease, and that these problems lead to various psychiatric disorders such as adjustment disorder, anxiety disorders and depression due to both cancer and side effects of treatment. 

CBT, which is one of the psychosocial developments for cancer patients, focuses on recognition and improvement, changing incompatible thoughts and behaviors, and improving the quality of life. It is used to make the patient feel better in daily life during cancer treatment.

How effective is CBT on cancer patient’s psychology?

There is substantial evidence for psychotherapy as an effective treatment option for cancer patients. However, there are no direct comparisons between cancer-specific and non-cancer-specific effective treatments which limits the ability to determine if one type of treatment is more or less effective than another.
Evidence suggests that a wide range of psychological therapies may be helpful in overcoming cancer related distress but it is not clear what elements of each type might be critical. In order to better understand the impact on cancer patient’s psychology, more research on how different types of therapy compare from a clinical perspective would need to be done.

cbt
What is CBT? Source: opencuny.org

However, the objectives of the CBT are to increase the sense of control to raise morale and to develop coping strategies that are appropriate to the solution of problems. CBT is for both individual and group therapy, and especially for cancer patients.

There are different protocols according to the type of cancer and emotional disorders such as anxiety problems, depression, and adaptation problems that occur after the stage.

The effectiveness of CBT in psychiatric disorders in cancer patients has been evaluated in many studies and its benefits have been indicated. In addition, it’s effective in reducing treatment side effects such as fatigue and insomnia. Indeed, in recent years researches revealed that one-third of the psychosocial interventions on cancer patients were primarily cognitive-behavioral therapies. The dissemination and implementation of such studies will contribute to the improvement of the quality of life of cancer patients.

Depression

Depression is a serious health problem that adversely affects the quality of life of cancer patients. They’re at high risk for persistent depressive symptoms and disorders; compared to the general population. It is important for doctors to know whether it is a normal cancer-related sadness or a symptom of clinically significant depressive disorder.

Diagnosing and treating depressive symptoms is crucial.

It is not easy to distinguish whether it is a symptom of depressive disorder or a normal sadness. And cancer patients usually ignore depression. Because many symptoms of depression, such as fatigue, weight loss, appetite, or sleep disturbance, can also mirror the physiological symptoms of cancer and its treatment and may prevent the diagnosis of depression.

Stiefel reported the effectiveness of psychological interventions in depressive cancer patients in his study. Psychotherapies (especially CBT) are effective in improving depressive symptoms in cancer patients in several small-scale studies. Cognitive behavioral approach decreases the level of depression and anxiety in cancer patients; due to the most recent studies on the effectiveness of CBT.

Cognitive-behavioral techniques are very useful and effective for the treatment of depression in cancer patients. In a meta-analysis study by Schneider et al., CBT is one of the most effective treatment methods for depression in cancer patients.

Anxiety Disorders

Anxiety disorders include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, specific phobias and post-traumatic stress disorder. Some researchers have reported that anxiety is a normal response to cancer diagnosis. And threats such as loss of body function, changes in appearance, family disintegration, death, etc. In patients with cancer, anxiety may first appear at the time of a life-threatening diagnosis. Physical reactions may include sweating, dyspnea, dizziness, and tachycardia. BDT is one of the most effective psychotherapy approaches in the treatment of anxiety disorder. 

Adjustment Disorder

Adjustment disorder is a mental health condition that develops as a reaction to an identifiable stressor or trauma. It manifests with symptoms such as detachment from work, school, family and friends; eating and sleeping changes; physical symptoms like headaches and fatigue; and behaving recklessly, including binge drinking or engaging in risky sexual behavior.

Suicidal behavior and length of hospital stay were longer in patients with adjustment disorder. For these reasons, it is important to recognize the adjustment disorder early in cancer patients and start treatment as soon as possible. Cognitive Behavioral Therapy is one of the most common psychological intervention approaches in cancer adaptation problems.

CBT encourages patients to identify excessive negative or irrational comments (cognitions) that patients have about their illness and life states, analyzes how these thoughts turn into dysfunctional behaviors, and then the therapist helps them gain more reasonable cognitions and more functional behaviors. It may also include training in relaxation techniques to manage stress. CBT also has a positive effect on emotional and functional adaptation to cancer.

Insomnia

Insomnia is the most common sleep disorder in cancer patients. Cancer-related insomnia can be classified as secondary or accompanying insomnia because it is related to a medical condition. Fleming stated that the patients were at high risk for insomnia because of the emotional consequences of a cancer diagnosis. Babson reported the existence of insomnia up to 5 years after cancer treatment.

Cognitive Behavioral Therapy for Insomnia in cancer patients has been developed in recent years. This program is based on the work of Morin that lasts 8 weeks for cancer patients and survivors ranging from 6-10 people for 90 minutes. It is a special form of CBT and at its core is to identify thoughts that cause insomnia and to change behaviors.

CBT is very promising in the treatment of cancer-related fatigue and insomnia. The most commonly used strategies within the CBT program are stimulus control, sleep restraint and relaxation therapies, paradoxical intent, sleep hygiene and cognitive restructuring.

Also, the reports say cancer patients with sleep disorders had significantly higher fatigue levels than patients without sleep disorders. Interestingly, this study states that fatigue was not an important determinant in patients with sleep disorders and depression.

This shows that the nature of cancer-related fatigue is different from its relationship to depression. It is an effective treatment to manage symptoms of fatigue in patients undergoing medical treatments for CB cancer. Gielissen evaluated the effectiveness of CBT in post-treatment fatigue levels of patients surviving cancer and showed that the fatigue level of the group receiving CBT was significantly lower than the control group.

Last Updated on December 15, 2023 by Lucas Berg

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