Supportive Expressive Therapy for Generalized Anxiety Disorder in Client with Burst Fractures Frankle - C

This article presents a case study of a client with burst fracture frankle-C. This client also has generalized anxiety disorder. Supportive expressive therapy was used as therapeutic intervention. A burst fracture is a type of traumatic spinal injury in which a vertebra breaks from a high-energy axial load. The psychological problems often experienced by persons with body disabilities, such as burst fracture francle-C. This is a quantitative research with a single client. While collecting the data, used interview methods (autoanamnesa and alloanamnesa), observation, and psychological tests (DAP, BAUM, BAI, and Sack’s Sentence Completion Test). The result before the practitioner gives the Beck Anxiety Inventory, the client’s anxiety is 20 (moderate anxiety), after intervention 15 (mild anxiety), and follow up 11 (mild anxiety). In addition, the client is also better able to understand his condition and the problems being faced. The catharsis process that has happened so far makes the client able to express what he feels and thinks so as to make the client feel the perceived burden is reduced. Clients can begin to open up to family members at home and conduct simple chats when parents are at home to reduce the habit of repression that was previously done. The technique and also the process of the therapeutic process along the therapy session will be discussed in detail.

Death talk and relief of death-related distress in patients with advanced cancer

ObjectivesThe circumstances of advanced cancer heighten the need for affected individuals to communicate mortality-related concerns, although there may be obstacles to such communication. Managing Cancer and Living Meaningfully(CALM) is a supportive-expressive therapy designed to address such barriers and to facilitate communication of mortality-related concerns in patients and caregivers facing advanced disease. This study explores death-related distress in patients with advanced cancer and the perceived influence of CALM therapy on overcoming barriers to communication of this distress.MethodsSemistructured interviews were conducted with a subset of patients with advanced cancer (n=17) participating in a CALM phase III trial at a large urban regional cancer centre. Interviews were transcribed, and qualitative data were analysed using thematic analysis.ResultsDeath-related distress was experienced in terms of three key themes: diffuse and overwhelming fear, fear of uncertainty and fear of suffering. The perceived barriers to communicating such distress were as follows: reluctance of loved ones to discuss mortality-related issues and the participants´ own reluctance to discuss death-related concerns to protect their loved ones or themselves from distress. CALM therapists were perceived to facilitate discussions on dying and death in sessions and to support patients´ communication of death-related distress with healthcare providers and loved ones.ConclusionsPatients with advanced cancer perceive barriers to effective communication of death distress to be related to their own reluctance, as well as reluctance of their loved ones to address such fears. CALM therapy may help patients with advanced cancer to overcome obstacles to communication and to alleviate death-related distress.Trial registration numberNCT01506492.

Meaning and existential givens in the lives of cancer patients: A philosophical perspective on psycho-oncology

Objective:Many cancer patients report changes in how they experience meaning in life and being confronted with life's limitations, understanding themselves as being vulnerable, finite, and free beings. Many would like to receive psychotherapeutic help for this. However, psychotherapy for these concerns often either focuses primarily on meaning in life (e.g., meaning-centered/logotherapy) or on existential givens (e.g., supportive–expressive therapy). The relationship between meaning in life and existential givens seems relatively unexplored, and it seems unclear how therapists can integrate them. The present article aims to explore the relationship between meaning and existential givens.Method:Martin Heidegger was a founder of existentialism, inspiring both meaning therapies and supportive–expressive therapies. Therefore, we systematically apply his understanding of these phenomena, elucidated by four elements in his central metaphor of “the house.”Results:(1) Walls: In everyday life, we construct ordinary meanings, like the walls of a house, to protect us from our surroundings, wind, and rain. (2) Surroundings (“existential givens”): Confronted with cancer, the meanings/walls of this house may collapse; people may start seeing their surroundings and understand that they could have built their house at a different location, that is, they understand the broad range of possibilities in life, their responsibility to choose, and the contingency of current meanings. (3) How to design, build, and dwell: People may design, build, and dwell in their house in different ways: they may lock themselves in their house of impermeable “ordinary meanings” and deny the existence of existential surroundings; they may feel overwhelmed by all possibilities and be unable to experience meaning; they may build the house as their true home, use life's possibilities, and listen to their true self by building permeable “existential meanings.” (4). Navigator: People may experience inner guidance to navigate in designing, building, and dwelling in this house.Significance of results:Meaning in life and existential givens are intertwined. Therefore, we suggest that it is necessary for psycho-oncologists to address both. Further clinical validation is required.