It truly sucks: not only do you have cancer, but you are very upset about having cancer. One doesn’t happen without the other. This might be a good time to talk to a professional about it. But… who?
“Something I didn’t know until I had cancer was that there are therapists who specifically specialize in supporting people who have cancer or chronic illness,” says Charlotte*, a 36-year-old painter, who was diagnosed with ovarian cancer two years ago.
Mental health disorders affect cancer patients at a higher rate than the general population, and it’s easy to see why. If you’re feeling things like depression, hopelessness, health anxiety, or even a loss of meaning, you’re not alone. It’s completely normal and these feelings don’t have to stay an inevitable part of the cancer experience. Even if you’re never spoken to a therapist before, studies have shown that psychological interventions, like talking with a therapist, counselor, or social worker can improve all of these symptoms. Seeking one out doesn’t make you any less tough or discredit the incredible support of your caregivers.
After 27 years as a breast and ovarian cancer counselor, Susan Hess says she understands what a cancer experience is like, and agrees that any mental health professional who’s worked in oncology likely does as well. She thinks that everyone when diagnosed with cancer would benefit from seeing a mental health professional with experience in oncology.
Any good therapist should be skilled at supporting someone through a life-changing, disruptive, and difficult event. But someone who has experience working with people facing a cancer diagnosis (whether it’s their own diagnosis or their loved one’s) is likely to have more insight, need less explanation, and provide more specific advice that you may find helpful.
Some Therapy 101s
To choose the professional that best aligns with your needs, it’s important to know the goals of each type.
Counseling: Hess explains that counseling is more about exploring your motivations and behaviors, and working with a counselor to alleviate the pressures of a specific situation in the present.
Therapy: Therapy is typically less focused on a specific situation and more often about making broad changes in behavior and thought patterns from repeated underlying issues.
Coaching: Coaching, Hess says, is very future oriented—more about setting goals and getting support to move towards those goals.
And a lot of these professionals have options for either in-person or virtual visits. This is largely personal preference, and can depend on your schedule, your comfort level, and maybe even the side effects you’re having from treatment. Most professionals have the option for a free consultation or free first session, so there’s no harm in taking advantage of these to find the one who fits all of your needs.
How to Find a Mental Health Professional
– Through Your Hospital
Your first point of contact will likely be the oncology social worker at your hospital. At Northwestern Medicine, where Robin Katz works as an oncology social worker, each patient fills out a questionnaire about mental health that might prompt a social worker to reach out. Katz says it’s likely the oncologist or nurse will ask you if you want to speak to a social worker, or you can ask for them to put you in touch with one.
While social workers are qualified to do therapy or individual treatments, they typically run support groups at their hospitals. Your social worker’s role, often, is connecting you with resources either inside or outside the hospital to support you, according to Sarah Kurker, an oncology social worker and professor of social work at Arizona State University. Kurker says they can provide you with referrals to therapists and counselors in the community and beyond, as well as with helping you find local nonprofits or other organizations that might be able to help you both mentally and financially.
– Finding a Nonprofit
Hess recommends connecting with a nonprofit associated with your diagnosis to get help finding referrals to local mental health professions with oncology experience. She helped start an organization called the Colorado Gynecologic Cancer Alliance, and suggests looking if there are similar resources within your state.
– Using a Specific Search Term
Sarah Murphy, a certified therapist who’s worked for breast and ovarian cancer patients for nearly 20 years, also suggests the myriad of searchable databases made for finding a therapist. She says typically, you can filter for therapists who work with cancer patients or just people with chronic illness. Murphy suggests sites like Psychology Today, Therapy Den, Alma, or Headway and filtering for your specific needs.Most of these websites allow you to specify you’re seeking a professional with experience in cancer or chronic illness, and take into account your insurance provider, as well as ask your preferences on gender, ethnicity, and if you prefer in-person or virtual options.
– How to Navigate Payment/Insurance
When it comes to payment, these filtering options on databases are helpful, but you can also check with your insurance company by calling them to ask about your mental health care benefit coverage, and typically they can walk you through which providers are in-network. You can also log in to your health insurance portal to search for clinicians who are in-network.
KrisAnn Talarico, a private practice therapist specializing in cancer with over nine years of experience as an oncology social worker, recommends talking to your social worker or primary care clinic to help you through all of this. If your insurance does not cover mental health services, your hospital may have options for mental health support and counseling, and by simply asking, you’re letting them know that this is something they should consider adding.
Why You Might Want to Find Someone Specialized in Cancer
As Hess explains, mental health professionals who have worked in oncology have experience with the specific psychosocial things—trauma, grief, and anxiety—that can be caused by cancer, and can help give you the perspective, knowledge, and skills you need to work through these emotions. They also are more likely to be familiar with the forms of treatment you may undergo, and associated side effects. It can feel exhausting to relive and explain the basics of your treatments and side effects, so by working with someone who has this background, you can avoid some of this.
When Charlotte was diagnosed with ovarian cancer, she found a therapist who specialized in chronic illness to speak to on an as-needed basis in times of crisis, in addition to her regular therapist. Charlotte says, “it was so relieving to talk to someone where I didn’t need to explain so much about my diagnosis. We could have a shorthand, and, at a time when I didn’t want to keep explaining what was wrong, that was so important.” And she found that, because this therapist had experience with chronic illness, she was able to give her somatic practice tools that helped deal with pain, illness, and unknowns of the body.
“She also was really good at health anxiety, which I had never had before, and then I think I was able to avoid it because she gave me a handful of strategies pretty early in my experience,” Charlotte says. “I’m lucky I did seek someone out because of the specificity she could provide.”
Also, If You Have a Therapist You Already Like, It's Not Necessary to Change–
Murphy also stresses that if you already have a relationship with a therapist, there’s no need to find someone with experience in oncology. She says sometimes it can be helpful to find other tools and techniques from someone who has more experience with your new life change, and many therapists will also refer their clients to briefly talk with someone experienced in oncology.
“If [you] have a great relationship with a great therapist and [you’re] going through a huge traumatic crisis, which a cancer diagnosis is, you may not want to find somebody who specializes in cancer and I’m pretty sure that your therapist will be able to help you,” Murphy says. “You don’t have to make a change or put any more pressure on yourself.”
It’s most important to find someone you’re comfortable with. And you may need some time to reach this level of comfort, but if things are feeling off with a therapist, you don’t have to push through. Going to therapy should be a source of relief, not a new source of stress. There are plenty of therapists, counselors, and coaches out there, and there will be one who’s a great fit for you and your needs.
*Names and some identifying details have been changed at the speaker's request.
