Psychological Support and Therapy in Oncology and Palliative Care at Guildford Hospital

What is psychological support and therapy in oncology and palliative care?

Psychological support and therapy is talking-based help from psychologists and counsellors for anyone affected by cancer or a life-limiting illness. It is designed to help you, and the people close to you, manage the emotional side of diagnosis, treatment and the road ahead.

What conditions does it treat?

This support is for anyone affected by a cancer diagnosis, from diagnosis through treatment, remission and, if it happens, recurrence. It is equally available if you are receiving palliative or end of life care, whether your illness is cancer or something else.

You might be offered support if you are:

• adjusting to a new diagnosis
• struggling with anxiety, low mood or fear about the future
• finding it hard to talk with family about what is happening
• worried about changes to your body or how you look
• grieving the loss of your health, independence or usual role
• coping with a fear that your cancer will come back.

Family members, partners and carers can be offered support too. This is not limited to the person who is unwell.

What are the benefits of psychological support and therapy?

Psychological support has been shown to ease distress and improve quality of life for people affected by cancer. It can help you make sense of what has happened and find ways of coping that work for you, rather than facing everything alone.

Support can also help you take part in decisions about your care, and for some people it makes it easier to go ahead with treatment they might otherwise find too frightening, such as scans or injections if you have a needle phobia. For families, it can improve communication and understanding at a difficult time, and help everyone involved feel less isolated.

Are there different types of psychological support?

Support is matched to how much you need, from a listening ear and information at your cancer appointments, right through to specialist input from a clinical psychologist or psychiatrist if your distress is severe.

Depending on what suits you, this might include:

• cognitive behavioural therapy (CBT), which helps you spot and change unhelpful thought patterns
• acceptance and commitment therapy (ACT)
• compassion focused therapy (CFT)
• mindfulness-based approaches
• existential psychotherapy, which explores difficult questions about meaning and mortality
• counselling, individual therapy, family therapy or group sessions
• complementary therapies such as massage, reflexology or relaxation techniques, alongside your psychological care.

Sessions can take place in person, over the phone, or by video call, depending on what is available and what works for you.

What happens before you start?

You can usually refer yourself, or ask your GP, oncology team or palliative care team to refer you. Any healthcare professional involved in your care can normally make this referral with your agreement.

Once you have been referred, the service will usually contact you by phone, or sometimes by letter, to arrange your first appointment. This first session tends to last up to an hour. Your psychologist will ask about:

• your diagnosis and medical care so far
• how your health is affecting your day-to-day life, and how you are coping
• other parts of your life, such as work and family, that might be relevant.

There's nothing you need to prepare beforehand. This conversation simply helps your psychologist understand your situation and work out, together with you, whether this service is the right fit, or whether another type of support would suit you better.

What happens in your sessions?

1. You have an assessment appointment with a psychologist or counsellor, as described above.
2. Together, you agree a treatment plan, choosing the type of support and therapy that best matches your needs.
3. You attend regular sessions, usually around 50 minutes long, which may be one-to-one, with your family, or in a group.
4. Your sessions use techniques such as CBT, ACT, mindfulness or compassion focused therapy, depending on your plan.
5. You have regular chances to tell your psychologist how the therapy is working for you, so your care can be adjusted if needed.

What does ongoing support look like?

Because this support is talking therapy rather than a hospital procedure, there's no hospital stay involved. Appointments happen in a clinic, at a hospice, or by phone or video call, and you go home after each session.

How long treatment lasts varies a lot from person to person. Some people find a few sessions are enough to help them cope on their own, while others benefit from longer-term support. If you and your psychologist agree that now is not the right time for therapy, you can ask your care team about a re-referral later, whenever the time feels right for you.