Psychotherapeutic interventions in melanoma patients.

Abstract

OBJECTIVES: The need for and the effectiveness of psychotherapy in the treatment of patients with skin cancer have been shown. However, only insufficient data are available to answer the questions as to what kind of psychotherapy is useful and how psychotherapeutic interventions should be designed. METHODS: During the past 7 years we performed crisis intervention, focal therapy and longer-lasting psychodynamically orientated psychotherapy within a consultation liaison service with the Department of Dermatology of Innsbruck University Hospital. We investigated the type of interventions using qualitative content analysis of the written records of weekly supervisory sessions. RESULTS: Standard methods of psychotherapy are often not appropriate for the confrontation of tumor-related fears in melanoma patients. Modifications of psychotherapeutic interventions and more structured support are necessary to meet overwhelming negative emotions caused by the existential threat of the disease. Therefore, we turned to using expressive-supportive methods combining psychodynamic psychotherapy with relaxation, imaginative methods, and structured picture drawing. CONCLUSIONS: Psychotherapists treating skin cancer patients should receive special education in such methods. To better cope with distressing emotions and to avoid burn-out and withdrawal from severely ill or dying patients, psychotherapists should take part in peer supervision regularly.