Some individuals face an increased risk of severe distress, for instance, if they:
- Had experienced major mental health problems such as depression in the past
- Have other serious medical complications apart from cancer
- Face communication problems (for instance hearing problems or a different language)
- Are facing some kind of family or social problems
- Are younger
- Are living alone
- Have young children to take care of at home
- Have had experienced very high levels of stress (even before the diagnosis of cancer)
- Have had a history of alcohol or drug abuse
If any of the above applies to you, there is an increased likelihood that you may require help from other people – referrals to the right people can be provided to you by the cancer care team.
You along with your cancer care team members may also realize that on certain occasions during the course of the disease and treatment, you face an increased risk of severe distress. Cancer has often been described as something similar to “being on a roller coaster”. Usually these occur at specific points of change during the course of the disease and its treatment:
- Having a new symptom that looks suspicious
- Changing treatment
- Going home after being discharged from the hospital
- Completing treatment
- Going for follow-up-visits to your cancer doctor
- The cancer recurs (comes back)
- Treatment failure
- The cancer worsens or reaches advanced stage
- Advancing towards the end of life
- Moving onto hospice care
In case you experience moderate to severe distress levels during these periods, you may require additional help.
Counseling services that you may require
The type of problems you may be facing and your distress levels will make it easier for you to decide the type of services that may be most useful for you.
Social work
In majority of places, the first support person you may come across is likely to be the social worker who acts as the “first responder”. When your cancer care team needs to refer you to another expert for your distress, your situation will be assessed by a social worker to check whether your distress is due to psychosocial or practical problems.
Psychosocial problems: The term psychosocial has been derived from the combination of mental or psychological health and social circumstances or aspects. Given below are a few examples of psychosocial problems:
- Having problems with adjusting to illness
- Facing family and social isolation
- Conflict in family
- Having problems with treatment decisions
- Worried about the quality of life
- Trouble coping with changes in care
- Trouble making decisions about future medical care (advance directives)
- Experiencing neglect or abuse at home
- Facing coping issues or having trouble communicating
- Changes in the thought process and your feelings about your body and perception of your sexual self
- Grief problems
- Issues related to end of life
- Cultural problems
- Caregiver related issues or the need to get ready for caregiving and initiate caregiver support
Social workers help patients and their families facing psychological problems by:
- Teaching patients and their patients
- Providing support and education group sessions to patients and their families
- Providing you with resource lists and locating community resources where you may find the required help
- Providing counseling to patients and their families about grief and relationships
These will be most effective when the level of distress is reasonably low (4 or less).
In case the problems are of a more serious nature, patient and family counseling or psychotherapy can be initiated. Patients and/or their family members can also be referred to psychosocial or psychiatric therapy or pastoral counseling, and specific problems may require grief or sexual counseling. Community resources may also be offered by the social worker to help families facing serious issues, for instance organizations that provide help to women who may have faced abuse at home.
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