Living with and beyond a diagnosis of cancer is associated with increased risk of psychological morbidity. Much research has highlighted the need to improve the identification of cancer patients and survivors who may benefit from psychological assistance. Once barriers to the identification of such patients are overcome, however, patient-centered barriers to accepting psychological help are also evident. Of those cancer patients who are identified as being distressed, anxious or depressed, a referral to psychological services is only desired or acted upon in 25% to 36% of cases. There has been very little investigation into the large proportion of cancer patients who, once identified as being distressed, anxious or depressed, opt not to pursue psychological treatment once it is offered. Our studies are examining barriers to cancer patients and survivors accepting psychological treatment when it is offered and factors influencing this decision, as well as investigating how engagement is maintained once treatment begins. The views and experiences of both cancer survivors and psychologists who treat cancer patients and survivors are being examined. Fear of Cancer Recurrence (FCR) is one of the most frequently reported concerns related to cancer survivorship, and is associated with anxiety, depression, and reduced quality of life. Cancer survivors who have clinical levels of FCR (assessed using the 42-item Fear of Cancer Recurrence Inventory) and have been offered psychological treatment, are being recruited for semi-structured interviews about engagement in treatment. Psychologists are being recruited to participate in an expert panel to create guidelines for best practice in engaging cancer patients and survivors into psychological treatment. It is hoped that these studies will identify potential strategies to better manage the psychological impact of cancer and cancer survivorship.