Psycho-oncology

Domain IX · Biomedical, neuro & digital

What it is

Psycho-oncology is a field and a service framework, not a single therapy. It is the psychological, social and spiritual care of people affected by cancer (patients, partners, families, children, bereaved relatives), delivered alongside oncology care. In practice it combines (1) routine distress…

Format

• Level 1. All cancer staff. For mild or recent worry and for information needs about decisions. Assessment is informal recognition. Interventions are information, compassionate communication, emotional support, listening, peer and group support, complementary therapies, and signposting.
• Level 2. Staff with additional psychological expertise. For moderate or persisting worry, symptoms such as pain or fatigue that are affecting quality of life, and mild adjustment difficulties. Assessment is distress screening (for example, a needs assessment or GAD-7). Interventions are active…

Who practises it, and how they are trained or regulated

• Level 3. Trained and accredited psychological therapists. For significant mood problems (depression, anxiety or panic, anger, hopelessness, suicidal ideation), treatment-related problems (procedural distress, feeling overwhelmed, distress that blocks engagement with treatment) and difficulties adjusting after treatment. Assessment is a semi-structured interview. Interventions are counselling and specific…
• Who delivers. CALM trial therapists were master's-level social workers and psychiatrists; the authors state psychologists and clinical nurse specialists can deliver it after training (a 2-day workshop, at least two supervised cases, and ongoing supervision with audio review). IMCP trial therapists had at least a master's degree in mental health counselling, social work or psychology, with workshop training, boosters…

Evidence status, as the guide reports it

• Choosing among programmes: high distress with advanced disease → CALM. Demoralisation, loss of meaning, or desire for hastened death with intact cognition → IMCP. Disproportionate fear of recurrence or progression, with checking, reassurance-seeking or avoidance of follow-up → ConquerFear. A major…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• shame preventing disclosure.
• the "good" sibling who hides distress.
• feeling guilty about enjoyment; normalise it.
• grief surfacing strongly; slow down and allow it.
• regrets and unfinished business; note these for C5.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.