Group Therapy For Cancer Patients: A

This extraordinary resource celebrates and expands on Dr. David Spiegel's discovery that a shared intimacy with mortality creates very different concerns in the patient from those that apply in conventional settings. Spiegel and Classen introduce mental health professionals to the awareness as well as the tools they will need to facilitate groups coping with existential crises. The result is a model for helping that actually helps.

David Spiegel, M.D. (Professor, Stanford School of Medicine), is a psychiatrist and author known for the study in which this book is rooted and for his related work on dissociation and hypnosis. Catherine Classen, Ph.D. (Professor, Stanford School of Medicine), collaborates with him on researching the benefits of group psychotherapy and conducts workshops for cancer patients internationally.

Acknowledgments

xi

Introduction

1

(12)

Part I: Rationale for Involving Cancer Patients in Group Support

Experiencing Cancer

13

(14)

The Diagnosis

14

(3)

A Changed Self-Image

17

(1)

Stress and Distress

18

(4)

Social Isolation

22

(1)

Social Support

23

(3)

Conclusion

26

(1)

Goals and Effects of Group Support

27

(30)

Goals of Supportive-Expressive Psychotherapy Groups

28

(14)

Evidence for the Benefits of Psychotherapeutic Interventions

42

(11)

Conclusion

53

(4)

Part II: Structuring Support Groups for Patients Coping with Serious Medical Illness

Guidelines for the Therapist in Structuring and Maintaining a Group

57

(34)

Considering Types of Cancer

57

(2)

Considering Stage of Disease

59

(4)

Optimal Timing for Joining a Group

63

(1)

The Length and Size of the Group

64

(1)

Open Versus Closed Groups

65

(1)

Providing a Safe and Successful Environment for the Group

66

(15)

Initial Session

81

(3)

Early Sessions

84

(6)

Conclusion

90

(1)

Treatment Strategies and Options for the Therapist

91

(38)

The Basic Treatment Strategies

91

(27)

Suggestions for the Final Sessions

118

(4)

Working with a Co-leader

122

(4)

Conclusion

126

(3)

Building Group Support

129

(14)

Support That Occurs Naturally

129

(2)

Facilitating Supportive Interactions

131

(1)

Handling a Problematic Expression of Support

132

(2)

Identifying Missed Opportunities for Mutual Support

134

(1)

Managing Disagreements

135

(1)

Building Outside Support Among Group Members

136

(5)

Conclusion

141

(2)

Encouraging Patients to Explore Their Experience and Express Their Emotions

143

(26)

Rationale for Open Expression

143

(3)

Facilitating Emotional Expression in the Group

146

(14)

Therapists' Emotions and Transparency

160

(5)

Conclusion

165

(4)

Part III: Helping Patients Manage Their Existential Concerns

Dealing with Dying

169

(22)

The Existential Orientation

169

(1)

Discussing Dying

170

(3)

Exposure to Coping with Dying

173

(8)

The Cost of Not Facing Death

181

(2)

Bringing Concerns About Death to the Surface

183

(3)

The Problem of Assisted Suicide

186

(3)

Conclusion

189

(2)

Dealing with Isolation, Meaning, and Freedom

191

(18)

Isolation

191

(4)

Meaning

195

(5)

Freedom

200

(5)

Working with Existential Concerns in the Context of Religious Beliefs

205

(1)

Conclusion

206

(3)

Part IV: Managing Group Problems and Special Situations

Facilitating Family and Specialized Groups

209

(28)

Family Groups

209

(20)

Groups for Other Illnesses

229

(6)

Conclusion

235

(2)

Group Problems

237

(16)

Confrontations Among Group Members

237

(2)

Scapegoating

239

(1)

The Monopolizer

240

(1)

The Silent Member

241

(2)

The ``Special'' Member

243

(2)

The Help Rejector

245

(2)

The Psychiatrically Distressed

247

(1)

The Hostile Member

248

(1)

When Members Leave

249

(1)

Conclusion

250

(3)

Methods of Pain Control

253

(18)

Reducing Muscle Tension and Diverting Attention from Pain

254

(1)

Reducing Depression and Pain and Interpreting Pain

255

(5)

Teaching Hypnosis in the Group Setting

260

(9)

Conclusion

269

(2)

Afterword

271

(8)

Psychological Outcome of Supportive-Expressive Group Therapy

271

(4)

Effects of Group Support on Health Outcomes

275

(4)

References

279

(18)

Index

297

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Group Therapy For Cancer Patients: A Research-based Handbook Of Psychosocial Care

Summary

Author Biography

Table of Contents

Supplemental Materials