Running Head: COPING WITH TERMINAL ILLNESS

Coping with Terminal Illness

Health Psychology U09 PSY358

COPING WITH TERMINAL ILLNESS

Coping with Terminal Illness

There is no right nor wrong way to live with terminal illness. Receiving a terminal
diagnosis can incite a wide range of emotions including shock, fear, and denial. It is common to
feel isolated, even in the presence of family and friends. The effects of positive psychology and
the healthy coping habits are essential to end-of-life care and even the ability to survive some
types of disease.
Martin Seligman believes in the idea of psychological science being used to identify and
nurture strengths. Some patients have experienced reactive depression often triggered by their
diagnosis. This can lead to many types of stress disorders or physical symptoms (Central CT
State University, 2005). Treatment should be small gradual steps with increasing difficulty over
time. The patient will begin to develop emotional gains and believe they still have control over
their lives. Seligman believes the best prevention for helplessness is early experience with
mastery and the experience will act as a buffer (CCSU, 2005). Positive psychology has shown to
focus on resilience, going beyond recovery and what makes life worth living. Focus on
prevention rather than treatment is a key goal of positive psychology (CCSU 2005).
In 1999 Dr. Fawzy Fawzy published a review of psychosocial intervention methods for
patients with cancer. Intervention methods are reviewed for successful outcomes, as well as what
does not work with patients. Dr. Fawzy also explores mechanisms for positive outcomes, a
model for designing psychosocial interventions and guidelines for assessing psychosocial
intervention. The methods of intervention reviewed were education, coping, emotional support
and psychotherapy. These formats were evenly divided between group and individual
intervention.

COPING WITH TERMINAL ILLNESS

In 1984, Worden and Weisman conducted a short-term intervention program studying

effectiveness of lowering distress and improving coping in newly diagnosed cancer patients (n =
371). Patients were screened and those with high risk for emotion distress and poor coping (n =
117) were randomly assigned to one of two short-term interventions (n = 59) or to a control
group (n = 58). The intervention groups were divided between patient-centered focusing on
problem improved health over time or progressive muscle relaxation. All patients had follow-ups
at 2 and 6 months, with the patients in intervention groups exhibiting significantly lower levels
of emotional distress and higher levels of problem resolution than the controlled group (Worden,
J.W., Weisman, A.D, 1984).
In another short-term program, Greer, Moorey and Baruch compared the quality of life of
156 patients with cancer receiving 8 weeks of psychological therapy including a brief problemfocused CBT program developed for the needs of individual cancer patients and patients
receiving no therapy (Greer, S., Moorey, S., Baruch, J.D.R, 1992). At the conclusion of 8 weeks,
patients who received therapy had higher scores of fighting spirit with lower scores of
helplessness, anxious preoccupation, depression and fatalism (Greer, 1992). After one year,
Moorey reported 19% of therapy patients showed signs of clinical anxiousness compared to 44%
of control patients (Moorey, S., Greer, S., Watson, M., 1994).
In contrast to the short-term programs, Maguire and associates studied the long-term
effectiveness of counseling on the psychiatric morbidity associated with mastectomy. Patients (n
= 75) had individual counseling sessions before surgery and one week after aimed at providing
information, advice and practical and emotional support from the time of admission to 12 months
after surgery (Maguire, P., Tait, A., Brooke, M., Thomas, C., Sellwood, R., 1980). In contrast,
control patients (n = 77) received routine medical care without clinical psychological support.

COPING WITH TERMINAL ILLNESS

Follow-up sessions occurred between 12 and 18 months after surgery. Unexpectedly, individual
counseling failed to prevent morbidity within the first year, but it still showed a beneficial result.
Regular monitoring of these patients resulted in a referral to 76% of patients needing psychiatric
care (Maguire, 1980). This is significantly higher than 15% of the control group that was
recognized and referred appropriately. The end result showed less morbidity in the counseling
group (12%) compared to the control group (39%) 12 to 18 months after mastectomy (Maguire,
1980).