Thursday 17th June 2021

Clinical Psychologist Dr Laurie Josephs

What is a teenage and young adult cancer psychologist?

A psychologist is someone who is trained in ‘talking therapy’. Even though we are called ‘doctors’, we are not medically trained and seeing one is very different to seeing a medical doctor. There are no invasive procedures, scans or medications.

Instead, we support people with how they are feeling and any difficult thoughts they may be experiencing. Psychologists work across many different areas, but teenage and young adult (TYA) cancer psychologists are specialised in supporting young people living with and beyond cancer. 

As cancer psychologists, we know that managing cancer can be hard both physically and emotionally. Some of the things we often support young people with include: 

  • struggling to cope after a diagnosis (e.g. anxiety, low mood)
  • managing difficult procedures or side effects of treatment 
  • the impact of cancer on family/friendships/relationships
  • the impact on college/university/work 
  • body image
  • worries around relapse or uncertainty around the future. 

There is no ‘right’ reason to see us and sometimes you might not know what you want support with – that’s OK too. We can navigate this with you and together we can work towards figuring out what the difficulties are for you, and getting the right support in place.

What is involved in seeing a psychologist? 

The first time you see a psychologist can be daunting and anxiety-provoking – we really understand this! It is our job to make you feel comfortable so let us know if you are feeling worried and we’ll do what we can to make it feel easier. 

Some people find that coming to just one session and seeing what it’s like really helps to take the pressure off committing to anything you aren’t sure about. 

The first time you meet with a psychologist, we like to ask questions to get to know you and help us to get an idea of what some of the difficulties are for you. You don’t need to know the answers to all these questions, and it is always okay to say you aren’t sure or you don’t know. It’s also a good time for you to ask any questions you might have.  

What therapy is:

  • A private space to talk about what’s most important to you. 
  • A non-judgemental, safe place.  
  • Time-limited – you won’t see us forever! Often, we see people for a certain number of sessions, but this is always reviewed throughout, so it won’t just suddenly end. 

What therapy is not: 

  • Compulsory – you don’t have to do it if you don’t want to! It won’t be helpful if you are forced into it – you have to want to do it.
  • Seeing a psychologist doesn’t mean you are ‘going mad’ or not coping or that you’re ‘a failure’. 

Is seeing a psychologist confidential? 

We will always let you know at our first appointment together that what we talk about will stay private between us. The only exception to this is if you tell us that you or someone else is at risk of harm. We have to share this information to make sure we are getting you the right support and keeping you and others safe. We will always do our best to let you know if we need to do this. 

Sometimes it may be helpful for us to think about sharing some information with your medical team – but we will always talk to you about this first and think together about how and what you want to share.

Types of talking therapy

There are different types of therapies that psychologists are trained in, and together we can figure out what would be the best fit for you. Sometimes we might use parts of different approaches to give you the best possible support. Some of the main approaches we use include: 

Cognitive Behavioural Therapy (CBT)

CBT focuses on making links between what we do, think and feel. Often, we get can get stuck in vicious cycles which keep some problems going. CBT can be a good approach to help us to notice these patterns and develop skills to overcome them. It does require some commitment and motivation as a lot of the skills need to be practiced – this helps to develop your own ‘toolkit’ of skills you can use when faced with challenges. 

Acceptance and Commitment Therapy (ACT)

ACT is slightly different to CBT as it is an approach which doesn’t try to change our thoughts but helps us to find ways to observe them in a non-judgemental way. ACT is useful for helping us to clarify what is important to us (our values), and how to make choices in life that are in keeping with these. The aim of ACT is to find a way to live your life meaningfully. 

Trauma-focused therapy

Going through cancer treatment can be, at times, traumatic. Some young people find that they struggle with things like flashbacks, nightmares or feeling as though parts of the trauma are happening all over again. Post-traumatic stress disorder (PTSD) happens when our brain isn’t able to fully process the traumatic event and it gets ‘stuck’ in the threat system. There are specific therapies that psychologists are trained in for trauma, which help to reduce the distress associated with the memories and help to pack them away so that they don’t show up involuntarily through flashbacks or nightmares.  

Solution-focused therapy

This form of therapy focuses on finding solutions to problems and identifying the skills and strengths you have, rather than focusing on the problems and difficulties. As an approach, it focuses on what you want to achieve in the future rather than exploring past experiences. 

Seeing a psychologist virtually: pros and cons

The coronavirus pandemic has thrown up many challenges for us all, but a silver lining is that it has enabled us to connect virtually via video calls. Many psychological services are offering virtual appointments now, which can make it easier for some people to attend therapy sessions. 

It is up to you what you feel most comfortable with – you might find that you end up doing a mixture of both! Here are some pros and cons of having sessions through video calls that other young people have shared from their experiences. 

Pros of seeing a psychologist virtually: 

  • It feels more comfortable not having to come to the hospital where I see everyone in the medical team. 
  • I like having sessions where I can sit in the comfort of my own home. 
  • I like not having to travel – it’s cheaper, quicker and less stressful! 

Cons of seeing a psychologist virtually: 

  • Sometimes it’s hard to find a private space at home and then I can’t really talk openly if other people are in the house. 
  • The internet connection can sometimes be unreliable and that can be annoying if you are in the middle of talking about something difficult. 
  • Sometimes you just want to be in the same room as someone when you’re talking about your feelings.

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If you’re a young person going through cancer and you feel you’re struggling with your mental health, please do speak to your clinical team, Teenage Cancer Trust Nurse or Youth Support Coordinator. They’ll do whatever they can to help you, which may include referring you to specialist support.

If you or someone else is in crisis and needs urgent help or further support, please visit: https://www.teenagecancertrust.org/get-help/urgent-help