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Counselling: it's good to talk

There is no doubt that a diagnosis of cancer has significant emotional impact both on patients and those around them. This is quite 'normal'. However, it is known that approximately one third of patients develop depression and/or anxiety which affects their ability to function on a day-to-day basis. Talking therapies may help.

Counselling is a talking therapy that aims to provide people with the space and time to understand their experiences in a way that helps them feel better able to cope. It has been an integral service at the LJMC since the centre first opened and enables people to explore issues and concerns in a structured and confidential environment.

One patient told us, "My family were fabulous right from the start. They were always there for me, providing practical help and keeping my spirits up, but they had their own worries too. To be able to talk to an independent person who wasn't emotionally involved in my cancer gave me the freedom to talk openly and adjust to what was happening."

There are many issues that present challenges for people following a cancer diagnosis. These include worries about the future, dealing with uncertainty, body image, relationship issues, low self-esteem, anger, panic attacks and phobias.

If someone wishes to receive counselling at the LJMC, all they need to do is speak to a member of the Drop-in centre team*. They will be invited to come to an initial appointment with a senior member of the Counselling team who will identify the most appropriate person to help them.

This session includes identifying some of the goals that the individual wishes to achieve as well as looking at other additional help that might be appropriate.

A practical example of this is if someone expresses concerns about their finances; a counsellor might suggest they also speak with the LJMC Benefits Advisor.

The team comprises professionals with a range of backgrounds and training, all of whom are fully qualified and accredited. They offer a range of evidence-based theoretical approaches including integrative, psychodynamic, cognitive behavioural therapy and art psychotherapy. They all have specialist experience of working with cancer patients.

At the LJMC we offer people up to six counselling sessions which usually take place weekly with the same counsellor. Focusing on cancer-related issues, the sessions can help individuals find coping strategies and discover self-help techniques for themselves.

It is not unusual that the team sees more women than men each year, reflecting the different ways in which people seek help. They see a wide age range of people from teenagers to octogenarians.

The team also works alongside others to provide a holistic service. They work particularly closely with the LJMC complementary therapy service to assist with managing anxiety and wellbeing.

The counselling service is available to support patients and carers at any point in their cancer experience. The end of treatment is a common time for people to refer themselves.

The milestone that marks the end of treatment also brings with it the desire to 'get back to normal', only for people to find that the goalposts have moved and 'normal' needs to be redefined.

Counselling can provide the opportunity to clarify and prioritise a person's concerns as they adjust to their new view of the world around them.

The LJMC service is not just offered to patients. A diagnosis of cancer affects more than just the patient and 30% of people coming for counselling at the centre are carers. Sometimes they may come for sessions with the patient although most people come for one-to-one sessions.

Recent media focus has highlighted the need for mental health to be given the same attention as physical health. Healthcare professionals are urged to address the emotional concerns of their patients and our team has been active in running training courses for healthcare professionals to give them the skills and confidence to broach these issues with their patients.

The team also supports our colleagues in the Cancer Centre in a variety of ways to help them deal with the stresses they face in a busy NHS environment.

For many people, talking things through is a helpful way to deal with issues both large and small. Other people find this difficult and we are fortunate to include an art psychotherapist in the Counselling team. Using different media, She is able to help people express their emotions in an alternative way.

Demand for the counselling service is always high but we endeavour to ensure that waiting lists are kept as short as we can.

If you have been struggling and think that talking to someone might help, please get in touch with us at the LJMC.

Call the Helpline on 020 3826 2555, or visit the centre, and staff will be happy to answer any questions you might have.

 

Case studies

Taking time to get better

When James finished treatment for throat cancer, he expected to get back to his normal, active lifestyle within days. Unfortunately, side effects from his treatment continued for several weeks and his struggle with the physical symptoms took its toll.

"I couldn't sleep properly and a lack of energy made me feel really low," he said. "The nurse and doctor kept telling me I was doing well and getting better but I didn't feel better and I found it really difficult to be optimistic."

As well as generally feeling poorly, treatment side effects also caused problems with eating. At meal times, James felt embarrassed, becoming withdrawn and isolated from his friends and family.

James' Clinical Nurse Specialist suggested he might find counselling helpful. Despite his doubts, James agreed to give it a go.

The counsellor helped James identify realistic goals in his recovery, encouraging him to be as active as he was able both to improve his mood and give him a sense of achievement.

He kept a diary of what he ate and was able to see improvement here too.

The counsellor also suggested James attend the LJMC relaxation classes where he learned techniques to help with sleeping.

"I was so impatient to be better," said James. "I've always been healthy so it was difficult to have to slow down and wait for my body to heal."

Finding a new 'normal'

When Caroline finished treatment for breast cancer she was relieved and looked forward to getting back to normal. She knew that life would be different but was shocked at how different it was.

She said, "I'd been through this huge experience and I imagined everything would get back to normal but it didn't. People treated me as if everything was normal but that was the last thing I felt.

"It took a while to pluck up courage to ask for counselling, because I really thought I should be able to sort myself out, but I realised that sometimes I have to ask for help."

At her initial assessment, the counsellor helped Caroline identify the key issues which were troubling her. These included how her priorities had changed following what she saw as a brush with mortality.

Having been a workaholic all her life, Caroline sought ways to help create a better work-life balance, recognising that there was more in her life than her job.

"So much had changed," she explained. "It was invaluable to be able to talk things through with someone who helped me make a little order out of the chaos. I explored new ways of coping that I simply wouldn't have found on my own. I've become better at saying 'no' to the things that aren't important, and 'yes' to the ones that are."

Caroline subsequently attended a HOPE course which built on what she had worked on during her counselling sessions.

Staying strong

When Claire was diagnosed with ovarian cancer, husband Tim took on the role of main carer, not just for Claire but also for their two children. Trying to juggle work with child care, taking Claire to hospital appointments and looking after the house and garden began to take its toll.

"Everyone told me I needed to look after myself and I knew they were right," he explained. "But it's easier said than done when

there are only 24 hours in the day and most of them are already full. I was trying to keep everyone happy and positive but it was really lonely. Being in our 30s, most of our friends had not had a close experience with serious illness and didn't really understand what I was going through."

When Tim brought Claire to the LJMC for complementary therapy one morning he started to talk with one of our Drop-in centre volunteers over a cup of coffee.

"Just talking and opening up to someone else was really helpful so, when she suggested I try counselling, I could really see that it might help", said Tim.

In the sessions, Tim explored his concerns for his family so that he could better support them without sacrificing his own wellbeing. He also found it helpful to identify the people in his life who were supportive and those who sapped his energy, developing coping strategies to maintain his inner strength.

"Counselling gave me space to articulate my feelings," said Tim. "It gave me a chance to say what I really felt to someone who wasn't going to judge me in any way."

 

 

 

Last updated: May 10, 2017

Counselling links

One approach used in counselling is to look at the way different aspects of our lives are inter-related

 

 

This article first appeared in the Summer 2017 issue of the LJMC newsletter, Open Door.

 

> Case studies about counselling also appeared alongside this article

> Information about the HOPE course for patients who have finished treatment

> Information about the Stepping Stones support group