Someone who understands: a qualitative study exploring cancer patients' experiences of psychotherapy in cancer care

Emotional distress is now recognised as the sixth vital sign of cancer and as such is not unexpected at any stage along the disease trajectory. It has gradually become an aspect of the disease that is recognised, monitored, documented, and promptly treated in many healthcare systems worldwide. Psycho-oncology is the specialist field concerned with the emotional distress of cancer. It focuses on understanding and treating the psychological impact of the disease and providing effective psycho-social care to all those affected by it, including patients, their family and friends and indeed clinicians working in oncology. Psycho-oncology is fast becoming an integral part of cancer care as an active and valuable area of research and practice, thus providing more knowledge and support within this specific healthcare field. This study explored cancer patients’ experience of their psycho-oncological care via the qualitative methodology, Interpretative Phenomenological Analysis (IPA). Exploring what psycho-oncology means to them and how it has impacted the cancer coping process, the study aims to further inform and develop research and practice in this specialist field. Much of the research thus far (both quantitative and qualitative) has investigated outcome measures and/or benefits of psychotherapeutic interventions used in cancer care. Studies have tended to be randomised controlled trials adhering to strict parameters of practice, including specific settings, models of therapy and number of therapy sessions. In order to gain a more subjective and ecologically valid understanding of this phenomenon, in-depth interviews were conducted with six cancer patients who have accessed and availed of psycho-oncology via different pathways within a real-life setting (the Republic of Ireland). Using IPA’s analytic techniques, three master themes emerged from the data - Cancer Patient Needs; The Power of Talking and The Therapeutic Relationship (with each theme containing three corresponding sub-themes) - all of which capture the essence of this experience. Results of the data imply that therapist values, flexibility of care and relational processes are deemed most meaningful and of benefit to cancer patients. Someone who has a professional and personal understanding and experience of cancer and disease processes in addition to embodying humanistic core values emerged as key factors in affecting therapeutic experience and outcome. Implications for such findings suggest that training and practice for psychotherapists working in cancer care need to emphasise a "being with" rather than a "doing do" style of therapy, capacity to discuss existential concerns and have a strong knowledge and experience of cancer