Treating Fear of Cancer Recurrence with Group Cognitive-Behavioural Therapy: A Step-by-Step Guide

Cancer is the leading cause of death in the United States. The improvement of screening procedures and treatments have led to higher survival rates, and consequently to an increased number of individuals who fear that their cancer might come back.

Fear of cancer recurrence (FCR) is defined as the fear, worry, or concern that cancer may come back or progress. FCR has been found to be the number one unmet need of cancer survivors. High levels of FCR are associated with greater psychological distress, impaired functioning, decreased quality of life, and increased medical consultations, psychotropic usage and health-care costs. It is therefore crucial to offer these patients an appropriate and effective treatment. The books first propose a theoretical model of FCR that identifies the five main targets of intervention in this program: 1) cognitive interpretation; 2) behavioural avoidance; 3) cognitive avoidance; 4) reassurance and control seeking; 5) intolerance of uncertainty. Then, each target is discussed and specific cognitive-behavioural therapy strategies are suggested that focus on each of them based on the best available empirical evidence for the treatment of anxiety disorders (e.g., generalized anxiety disorder) and cancer-related anxiety.

This book will be of interest to clinicians working with cancer patients such as psychologists and other health care providers as well as cancer patients and survivors. Graduate students in clinical health psychology, and connecting disciplines such as psycho-oncology, psychiatry, nursing, social work, rehabilitation, spiritual care, and sexology might also find this text of value.

Josée Savard, PhD, is a psychologist and full professor in the School of Psychology at Université Laval and a researcher at the CHU de Québec-Université Laval Research Center. Her research interests are centered on the psychological aspects of cancer, more particularly insomnia, depression, and fear of cancer recurrence. She has published in French a book for the wider public (Faire face au cancer avec la pensée réaliste [Facing cancer with realistic thinking], Flammarion Quebec) of which some of the content was adapted for this book. In 2020, she also co-edited the Handbook of Sleep Disorders in Medical Conditions (Elsevier), which was awarded the PROSE award of the Association of American Publishers for the best handbook in medicine and clinical science.

Aude Caplette-Gingras, PhD, is a psychologist and a scientist-practitioner specialized in psycho-oncology. She is also in charge of professional practices development in psychology at the CHU de Québec-Université Laval. She works at the breast cancer clinic of the CHU de Québec-Université Laval (Hôpital du St-Sacrement). She has accumulated 13 years of experience using CBT in this population for a wide range of psychological problems, including fear of cancer recurrence. She also trains psychology interns in psycho-oncology. 

Lucie Casault, PhD, is a psychologist specialized in oncology. She is head of the Department of Multidisciplinary Services at the CHU de Québec-Université Laval (CHUL) and has practiced CBT among cancer patients and supervised psychology interns in psycho-oncology for 20 years.

Jennifer Hains, D.Ps. is a psychologist specialized in psycho-oncology. She worked at the breast cancer clinic of the CHU de Québec-Université Laval (Hôpital du St-Sacrement) and now works at L’Hotel-Dieu-de-Quebec part of theCHU de Québec-Université Laval with patients who have different types of cancers. She has provided psychological services to cancer patients using CBT for 5 years.