Dr. Johns describes the interventions employed in her study on fear of breast cancer recurrence.
Transcript:
Acceptance and commitment therapy, we believe that that approach, in theory, works by supporting people in increasing what we call their psychological flexibility skills, and by that I mean being able to just notice what shows up in their life and then taking the wisest and most values-consistent action in response to that — so basically choosing how we’re going to respond rather than being flung around like a worm on a fishing hook whenever fear shows up.
And then cognitive behavioral therapy is designed to work by supporting survivors and identifying those sticky thoughts that just keep showing up for them and then looking at those thoughts a little bit more critically. So a thought like, “I would never be able to handle it if my cancer recurred,” we supported survivors in thinking it through, like, what would you do if your cancer recurred? What were three steps that you could take if your cancer does recur? “Well, I would get back in touch with my oncologist. I would follow evidence-based treatment guidelines. I would get the support that I need. I would take really good care of my body.”
So the survivors were able to see that they were not going to be powerless if their cancer recurred, and I think that was really helpful. Giving people a little bit more sense of confidence that, “You know what, I wouldn’t like it if my cancer recurred, but I would find my way through it.”
The survivorship coaching, we think that could have worked by helping survivors to get really focused on something that was meaningful to them and then taking specific action. So really, when you think about all three of these programs, the one common factor across all of these is we were trying to give survivors tools and resources that they could use to improve their quality of life and to manage that fear whenever it shows up.
Shelley Johns, PsyD, offers advice to friends and family of people living with breast cancer.
Transcript:
The take-home message for friends and family members here would be when you notice the tendency to want to tell a breast cancer survivor what to do or how they should be, I would encourage you to just notice that desire to give advice and bite your tongue, so to speak. I think asking more questions and giving less advice is probably the most useful strategy and the most supportive strategy because some of the breast cancer survivors in our study told us that they felt pressured from their friends and family members to be a certain way. And when they couldn’t be that way — as strong as everybody wanted them to be or as confident in their survivorship — that it actually made them feel worse, and it made them pull inward and to be less engaged with friends and family. Do much more asking and listening and less advice-giving unless invited to give it.
