Objective: Cancer is a potentially life-threatening disease that may lead to long-term traumatic stress in some, but not all, survivors. In addition, some patients may already, prior to their cancer diagnosis, have experienced other traumas contributing to this stress. This presentation will critically examine how the concept of trauma is defined and applied across different psychosocial cancer interventions.
Methods We draw on literature reviews on psychosocial cancer interventions to identify therapeutic approaches commonly tested internationally. We identify if and how different definitions of trauma are applied in some of the common types of psychosocial interventions (e.g. Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, nurse navigation), if they target trauma directly or if they are trauma informed and discuss this against the literature on long-term psychological consequences of trauma.
Results: In pediatric cancer, Pediatric Medical Traumatic Stress (PMTS) has e.g. been defined as “a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences” (Price 2016). Our conceptualization of trauma strongly influences the therapeutic techniques employed and shapes clinical expectations regarding patient experiences of trauma. While a small proportion of cancer survivors report severe, long-term psychological consequences, the majority recover well with existing social and professional support. It is therefore essential to distinguish between “cancer as a traumatic experience” and “cancer as an experience that may be traumatic or add to existing trauma for some,” and to tailor interventions accordingly.
Conclusion and Clinical implications: Psychosocial cancer interventions are often delivered with the implicit assumption that all patients experience trauma. However, there is a need for greater specificity in identifying when, and for whom, particular interventions are appropriate. A more nuanced understanding of previous and cancer-related trauma can help ensure that support is both targeted and effective.