Researchers have discovered that in-person cognitive behavioral therapy (CBT) sessions provide more benefits than virtual ones. CBT is designed to help individuals confront and reframe negative thought patterns, enabling them to progress in their lives.
Key Takeaways:
- A comprehensive meta-analysis of more than 130 studies indicated that CBT significantly improved the mental health of both cancer patients and survivors.
- The therapy appeared to have a greater impact on younger individuals diagnosed with cancer.
- In-person CBT sessions proved more effective than those conducted through telehealth or app-based platforms.
Impact of Cognitive Behavioral Therapy on Cancer Patients
Cognitive Behavioral Therapy (CBT) has long been recognized for its effectiveness in improving mental health and emotional well-being. Recently, a new systematic review has highlighted its significant benefits for individuals diagnosed with cancer and those who have survived the disease. This comprehensive study has found that CBT can improve not only mental health but also the quality of life for cancer patients and survivors. Interestingly, the impact of the therapy was notably stronger for younger individuals, and in-person therapy sessions appeared to be more effective than virtual ones.
Anao Zhang, PhD, a corresponding author and assistant professor of social work at the University of Michigan in Ann Arbor, confirmed the positive findings. “CBT is an excellent tool for helping people cope with the emotional distress that often comes with a cancer diagnosis,” says Dr. Zhang. The findings from this study may also help identify which cancer patients are most likely to benefit from CBT, potentially altering how therapy is delivered to individuals during and after cancer treatment.
All About CBT
CBT is a form of psychotherapy that helps individuals identify and change negative thought patterns and behaviors that adversely affect their emotions and overall well-being. The primary goal of CBT is to help people recognize distorted or unhelpful thought patterns, challenge them, and then replace them with healthier, more productive thoughts and behaviors.
Ian Sadler, PhD, a psychosocial oncology specialist at Columbia University Cancer Center in New York City, explains that patients facing a cancer diagnosis often experience overwhelming, intrusive thoughts. “Imagine a woman who’s just been diagnosed with breast cancer. That’s when these intrusive thoughts can take over,” he says. Many patients, especially women, often blame themselves for their condition, with thoughts like, “This is my fault because I smoked in college,” or “I didn’t follow a strict organic diet.”
CBT encourages patients to acknowledge these negative thoughts without judgment and to gently challenge them. “It’s not about stopping the thoughts—these will come. Our bodies are hardwired to react to threats, and it’s the sympathetic nervous system doing its job,” Dr. Sadler says. The key is to recognize that these negative thoughts don’t define reality and can be managed with the right therapeutic approach.
Results from a Comprehensive Study
To assess the effectiveness of CBT in cancer care, researchers conducted a meta-analysis that included data from over 13,000 participants across approximately 130 trials. The participants ranged in age from 4 to 76, with an average age of 58 years, and nearly 80% were female. The study revealed that CBT had a moderate impact on reducing depression and anxiety for both current cancer patients and survivors, irrespective of the type of cancer.
However, when CBT was delivered virtually, whether via telehealth or mobile applications, the benefits were less significant. The authors noted that this aspect requires further investigation to understand why virtual CBT sessions didn’t yield the same results as in-person therapy.
The study also explored the effects of CBT based on the age of the participants, grouping them into three categories: ages 4 to 39, ages 40 to 64, and those 65 and older. CBT showed clear benefits for the two younger groups, both in terms of mental health and quality of life. However, for individuals over 65, the benefits of CBT were statistically insignificant. This finding is particularly concerning because the majority of cancer diagnoses occur in older populations.
Dr. Zhang emphasizes that while the study doesn’t suggest CBT is ineffective for older adults, it points to potential challenges in delivering therapy to this age group. Therapists may need specialized training to navigate potential generational differences between clinicians and patients. “Older adults might need a different approach to therapy, and we need to further investigate how to make CBT as effective for them as it is for younger individuals,” he says.
How Do These Findings Compare to Previous Research?
These results align with existing research on the effectiveness of CBT for cancer patients. Barbara Andersen, PhD, a clinical psychologist and professor of psychology at The Ohio State University, has conducted numerous studies on the biobehavioral aspects of cancer. “CBT has consistently been shown to help with mood, anxiety, and overall quality of life in cancer patients,” says Dr. Andersen, who was not involved in the latest meta-analysis.
However, Dr. Andersen points out that the study’s findings regarding quality of life improvements might be understated due to limitations in how quality of life is measured. “It’s not that CBT doesn’t improve quality of life—it certainly does. But the tools used in these studies may not be the best at capturing those improvements,” she explains.
She also expressed skepticism about the age-related findings. “Combining children as young as four with people in their thirties for data analysis seems like a flawed approach,” says Dr. Andersen. This raises questions about whether the age groups were structured appropriately to provide accurate insights into the impact of CBT across different life stages.
How CBT Helps Cancer Patients Navigate Their Daily Life
CBT’s effectiveness comes from its structured approach to breaking down the connection between thoughts, emotions, and behaviors. Dr. Sadler suggests picturing a triangle, where each corner represents thoughts, emotions, and behaviors. When one element is affected, it influences the other two. For instance, a patient returning home after a chemotherapy session might think, “I feel terrible, so what’s the point of getting out of bed?” This thought could trigger emotions like sadness or hopelessness, which in turn reinforce the behavior of staying in bed.
CBT helps patients recognize these patterns and encourages them to take action, even when they don’t feel like it. “The reality is, sometimes getting up, getting dressed, and engaging with the world can help shift those negative thoughts and feelings,” says Dr. Sadler. However, he emphasizes that CBT isn’t about always being positive or denying negative thoughts. “It’s about becoming a keen observer of your thoughts and learning when to let go of unhelpful ones.”
One of the core techniques taught in CBT is how to stop ruminating on negative thoughts. Dr. Sadler suggests mindfulness exercises, such as focusing on breathing, to help patients let go of thoughts that could otherwise spiral into hours of distress. “If you can recognize a negative thought before it takes hold, you have the power to move on,” he says.
Moving Forward
As this meta-analysis shows, CBT can be a powerful tool for helping cancer patients and survivors manage their mental health and improve their quality of life. In-person therapy sessions continue to demonstrate stronger outcomes compared to virtual formats, though more research is needed to understand this disparity. Additionally, while CBT is effective for younger populations, it may require adjustments to meet the unique needs of older adults.
Understanding how to tailor CBT to each individual’s circumstances can ensure that more cancer patients and survivors receive the mental health support they need, helping them face the challenges that come with living through and beyond cancer.
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