Transcript Therapeutic techniques - Collaborative Family Healthcare Association

Session #B6
October 6, 2012
The Lived Experiences of Breast
and Prostate Cancer Patients and
Their Partners
Alison G. Wong, MA
University of Connecticut
Stephanie Trudeau-Hern, MS
University of Minnesota
Collaborative Family Healthcare Association 14th Annual Conference
October 4-6, 2012 Austin, Texas U.S.A.
Faculty Disclosure
We have not had any relevant financial relationships
during the past 12 months.
Objectives
• Identify the research rationale and clinical benefits of
medical family therapy in cancer care settings.
• Identify and address the physical, psychosocial, and
relational issues faced by breast and prostate
patients.
• Describe the self-of-the-practitioner challenges of
various therapeutic issues such as transference and
counter-transference, loss of client, and self care.
• Identify strategies to respond to the therapeutic
challenges.
Agenda
• Theoretical background
• Issues facing couples coping with prostate and
breast cancer
• Treatment approaches
• Self of the therapist issues
Illness can strike any family at any time. What
is significant is at what point in life, in what
form, and with what intensity they occur and
how long they persist. Perhaps most important
is how the experience of illness will
psychosocially affect the entire family unit
(Rolland, 1983)
The “We” Disease
Rolland’s Phase of Illness
Developmental Tasks
• Crisis Phase
– Life reorganization
– Adaption
– Flexibility
• Chronic Phase
– Renegotiation of relationships
– Uncertainty
• Terminal Phase
– Anticipatory grief
Issues Facing Couples with Cancer
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Initial diagnosis
During treatment
Post-treatment
Survival
Recurrence
Death and dying
Diagnosis
Themes
• I can’t believe this is happening to me
• How bad is it? Am I going to live?
• Waiting for treatment to start.
• Patient and caregiver enter unspoken contract to
focus on patient care.
Therapeutic techniques
•Brief solution-focused therapy
•What things can you control?
•What kind of patient & caregiver do you want be?
Treatment
Themes
• Treatment routine
• Medical family
• Partners
• Burnout
• Neglect of relationship starts to take a toll
Therapeutic techniques
•Family of origin issues
•Short (30 min) sessions
Post-Treatment
Themes
• What is my identity? Patient or survivor?
• Unknown and ambiguous
• Desire toward reorganization & reintegration
• Ok so back to normal, right?
Therapeutic techniques
• Narrative therapy
• Experiential therapy
Survival
Themes
•Major life changes
•Mourn loss of “old normal”
•What does it mean to be healthy?
•Recoupling: backburner couple issues move to the
front burner
Therapeutic techniques
•Narrative therapy
•Externalization of cancer
Recurrence
Themes
•Yep, I knew the other shoe was going to drop
•Influenced by previous cancer experiences
Therapeutic techniques
•Couple illness experience-directed
•Elicit the couple’s illness story
Death & Dying
Themes
Fears/beliefs around death
Doing relationships on purpose
Higher meaning, legacy, impact.
Leaving nothing unsaid.
Therapeutic techniques
•Narrative therapy
•Experiential therapy
•Construction of meaning
Other Issues
• Ambiguous loss
• Developmental issues
• Family lifecycle
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Gender
Sexuality
Body image
Intimacy
Self of the MedFT Issues
• Family of origin issues
• Secondary trauma
– Hyperawareness of illness
• Grief
• Isolation
– Personal and professional
• Transference and counter-transference
“Nothing ever becomes real ‘til it is
experienced.”
- John Keats
Session Evaluation
Please complete and return the
evaluation form to the classroom monitor
before leaving this session.
Thank you!