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Balancing Hope and Hopelessness in Family Therapy for People Affected by Cancer

Published online by Cambridge University Press:  02 March 2012

Peta McLean
Peta McLean*
Affiliation:
Royal North Shore Hospital, Sydney, Australia
*
Address for correspondence: Peta McLean, Social Work Department, Royal North Shore Hospital, Pacific Highway, St. Leonards, NSW 2065. Email: petamclean@hotmail.com
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Abstract

This paper discusses how the concepts of hope and hopelessness can affect therapeutic interventions when working with people affected by cancer. The concepts of hope and hopelessness are considered within the therapeutic relationship and the biomedical model. This explores whether there is a difference between hope and denial and considers how culture, religion, and spirituality influence an individual's interpretation of hope. For some people living with a cancer diagnosis, the word ‘hope’ can become a burden. They can feel a pressure to present as strong, positive, and hopeful in the face of extremely confronting situations. Therapists need to give patients time and space to explore their feelings of hopelessness without rushing them to a place of hope for which they are not ready. Case examples are provided and the author reflects upon her own family therapy practice working in an acute health care facility. This stresses the importance of critical reflection, supervision, and peer support.

Keywords

hopehopelessnesstherapycancerterminal illness
Type
Articles
Information
Australian and New Zealand Journal of Family Therapy , Volume 32 , Issue 4 , December 2011 , pp. 329 - 342
Copyright
Copyright © Cambridge University Press 2011

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References

Bertolino, B., & O'Hanlon, B. (2002). Collaborative, competency-based counselling and therapy. Needham Heights MA: Allyn & Bacon.Google Scholar
Bloch, D. A. (1984). The family therapist as health care consultant. Family Systems Medicine, 2(2), 161–169.CrossRefGoogle Scholar
Boss, P. (2006). Resilience and health. Grief Matters: The Australian Journal of Grief and Bereavement, New York: Norton.Google Scholar
Brooks, K. (2010, October 27). Alive to cancer's harsh realities. The Courier Mail, pp. 28–29.Google Scholar
Burgess, D. (1994). Denial and terminal illness. American Journal of Hospice and Palliative Care, 11(2), 46–48.CrossRefGoogle ScholarPubMed
Butow, P., Dowsett, S., Hagerty, R., & Tattersall, M. (2002). Communicating prognosis to patients with metastatic disease: What do they really want to know? Supportive Care in Cancer, 10, 161–168.CrossRefGoogle ScholarPubMed
Clayton, J. M., Hancock, K., Parker, S., Butow, P. N., Walder, S., & Carrick, S. (2008). Sustaining hope when communicating with terminally ill patients and their families: A systematic review. Psycho-Oncology, 17, 641–659.CrossRefGoogle ScholarPubMed
DelVecchio Good, M., Good, B. J., Schaffer, C., & Lind, S. E. (1990). American oncology and the discourse on hope. Culture, Medicine & Psychiatry, 14, 59–79.CrossRefGoogle ScholarPubMed
Edelman, S. (Ed). (2006). Change your thinking, Sydney: Australian Broadcasting Corporation.Google Scholar
Ehrenreich, B. (2007, February). Pathologies of hope. Harpers Magazine, 9–11.Google Scholar
Elliott, T. R., Witty, T. E., Herrick, S., & Hoffman, J. T. (1991). Negotiating reality after physical loss: Hope, depression, and disability. Journal of Personality and Social Psychology, 61(4), 608–613.CrossRefGoogle ScholarPubMed
Flaskas, C. (2002). Family therapy beyond postmodernism: practice challenges theory. New York: Brunner-Routledge.Google Scholar
Flaskas, C. (2007). Holding hope and hopelessness: Therapeutic engagements with the balance of hope. Journal of Family Therapy, 29(2), 186–202.CrossRefGoogle Scholar
Gibney, P. (2003). The pragmatics of therapeutic practice. Melbourne: Practice Psychoz Publications.Google Scholar
Gilchrist, J. (2008). Thriving as a health professional. In Hodgkinson, K. & Gilchrist, J. (Eds.), Psychosocial care of cancer patients: A health professional's guide to what to say and do (pp. 23–38). Melbourne: Ausmed Publications.Google Scholar
Glaston, C., & Mitchell, G. (2005). Information giving and decision-making in patients with advanced cancer: A systematic review. Social Science and Medicine, 61, 2252–2264.CrossRefGoogle Scholar
Gordon, E. J., & Daugherty, C. K. (2003). Hitting you over the head: Oncologists disclosure of prognosis to advanced cancer patients. Bioethics, 17(2), 142–168.CrossRefGoogle ScholarPubMed
Grazebrook, K., & Garland, A. (2005). What are cognitive and/or behavioural psychothera-pies? A paper prepared for a UKCP/BACP mapping psychotherapy exercise. Retrieved from http://www.babcp.com/babcp/what_is_CBT.htmGoogle Scholar
Irving, L. M., Snyder, C. R., & Crowson, J. J. (1998). Hope and coping with cancer by college women. Journal of Personality, 66(2), 195–214.CrossRefGoogle ScholarPubMed
Kubler-Ross, E. (1981). Living with death and dying. New York: Touchstone.Google Scholar
Laird, J. (1998). Theorizing culture: Narrative ideas and practice principles. In McGoldrick, M. (Ed.), Revisioning family therapy: Race, culture and gender in clinical practice (pp. 20–36). New York: Guilford Press.Google Scholar
MacDonald, M. & Hobbs, K. (2008). Grief, end of life and bereavement. In Hodgkinson, K. & Gilchrist, J. (Eds.), Psychosocial care of cancer patients: A health professional's guide to what to say and do (pp. 163–174). Melbourne: Ausmed Publications.Google Scholar
Marshall, C. A., Larkey, L. K., Curran, M. A., Weihs, K. L., Badger, T. A., Armin, J., & Garcia, F. (2011). Considerations of culture and social class for families facing cancer: The need for a new model for health promotion and psychosocial intervention. Families, Systems, & Health, 29(2), 81–94.CrossRefGoogle ScholarPubMed
McGoldrick, M., & Hines, P. M. (2007). Hope: The far side of despair. In Flaskas, C., McCarthy, I., & Sheehan, J. (Eds.), Hope and despair in narrative and family therapy: Adversity, forgiveness and reconciliation, (pp. 51–62). New York: Routledge.Google Scholar
McKennis, A. (1999). Caring for the Islamic patient. AORN Journal, 69(6), 1187–1185.CrossRefGoogle ScholarPubMed
Miller, L. (2006). Counselling skills for social work. London: Sage.Google Scholar
National Health & Medical Research Council. (2003). Clinical guidelines for the psychosocial care of adults with cancer, New South Wales: National Breast Cancer Centre.Google Scholar
Reimers, S. (2006). Family therapy by default: Developing useful fall-back positions for therapists. Journal of Family Therapy, 28, 229–245.CrossRefGoogle Scholar
Salander, P., & Windahl, G. (1999). Does ‘denial’ really cover our everyday experiences in clinical oncology? A critical view from a psychoanalytic perspective on the use of ‘denial’. Psychology and Psychotherapy, 72, 267–269.Google ScholarPubMed
Scher, S. (2010). Ethics anxiety. Australian and New Zealand Journal of Family Therapy, 31(1), 35–42.CrossRefGoogle Scholar
Scher, S., & Kozlowska, K. (2011). The clinician's voice and the limits of bioethics. Australian and New Zealand Journal of Family Therapy, 32(1), 15–32.CrossRefGoogle Scholar
Stephenson, P. S. (2004). Understanding denial. Oncology Nursing Forum, 31(5), 985–988.CrossRefGoogle ScholarPubMed
Vos, M. S., & de Has, J. C. J. M. (2007). Denial in cancer patients. Psycho-Oncology, 16, 12–25.CrossRefGoogle ScholarPubMed
Weingarten, K. (2010). Reasonable hope: Construct, clinical applications, and supports. Family Process, 49(1), 5–21CrossRefGoogle ScholarPubMed
Zayfert, C., & Berker, C. B. (2007). Cognitive-behavioral therapy for PTSD: A case formulation approach. New York: Guilford Press.Google Scholar