Update on CBT for People with Cancer

Cognitive behaviour therapies cover a broad spectrum of approaches based on social learning theory and sharing a common focus on thoughts, beliefs and behaviour as the primary vehicle for change. CBT has been applied to specific physical and psychological problems experienced by the person with cancer, such as pain, conditioned nausea, insomnia, fatigue, anxiety and depression, as well as to the broader issues of adjustment and coping. Therapies have been delivered as simple behavioural interventions, psychoeducational programmes and more complex cognitive behavioural therapies planned around a case formulation of the person's problems. These approaches continue to be researched and the body of literature supporting the evidence for CBT in cancer is growing. The presentation will review the current evidence and consider 2 main themes: firstly, how recent developments of CBT can be incorporated into work with people with cancer, and secondly, how CBT can be most effectively delivered in oncology and palliative care settings. Cognitive behavioural approaches developed in the last 10 years can make important contributions to working with worry and ruminations in people with cancer (Acceptance and Commitment Therapy; Mindfulness Based Cognitive Therapy; Metacognitive Therapy), helping people step outside the need to "fix" their problems. These more acceptance based approaches and the related Compassionate Mind Therapy can all be integrated into more standard CBT.  Novel ways of delivering CBT techniques through training nurses and other health practitioners, using telephone and online therapy and developing very brief, focused interventions can also give more patients access to treatment.