Your Guide to Support Services for You and Your Family

Fox Chase Cancer Center Information

Patient and Family Support

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About the Hospital

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Individual counseling

Individual counseling offers an opportunity for you to talk with one of our staff about what is worrying you and to figure out how to tackle those worries. We will ask questions about how you and your family are coping and what is worrying you the most. You might find that talking about the situation puts a different perspective on things. Thinking about how you have dealt with problems in the past may help you to figure out what to do next. We will help you prioritize your needs so greatest needs can be addressed first. You may talk about different ways to approach the situation before deciding what to try first. It is important not to get impatient or frustrated if your first approach doesn't seem to be working. Problem solving is often a stop and go process - you may try out a variety of possibilities before arriving at an approach which is right for your family.

You may feel very much better after one or two sessions with an oncology social worker. While that is a good thing and probably means you have found the right match for you, it may take longer to begin to feel better. It may be that what you are feeling is the relief that comes from sharing your worries with another person. Human behavior is very complex and not easy to change. Also, understanding why we feel and/or behave in a certain way doesn't necessarily mean we will be able to quickly feel or act differently. So give the counseling process enough time to decide how useful it might be.

We will probably also ask you what you understand about your medical situation to be sure that you have enough information to make treatment decisions. People need different amounts of information so our goal is not to tell you everything there is to know but to be sure you have the right information for you. In this regard, you may also be experiencing problems talking with your doctor or another health care professional. We can also help you sort out sensitive problems like that. Remember that all of the information you choose to share is confidential.

Family Counseling

Some professionals think that family counseling is the best way to cope with cancer because a diagnosis of cancer always affects families. Many things influence behaviors among family members. These are life experiences, personality, feelings, the quality of relationships, the family's stage of development (composed of young, middle aged or elderly people), cultural and racial issues, finances and family belief systems, to name a few. For instance, if a family believes that problems should not be shared with outsiders, that family might have difficulty accepting help. If a family believes that children can't deal with difficult things, that family would probably not be comfortable telling a child about a parent's cancer. These two belief systems can make a cancer diagnosis more difficult than it needs to be. Counseling may be helpful in trying to think about a problem in a new way.

One of the ways to decide about family counseling is to look at what is going on among the people you care about. Ask yourself the following questions:

  • Can I talk to my spouse about how I feel?
  • Is my spouse or partner able to listen to what I am saying or does it seem to be too painful?
  • Does it help to talk to the important people in my life when things are going badly?
  • Do my partner and I always end up in a fight about what we expect of each other?
  • Do my children seem more worried, sad or lonely than before the cancer?
  • Do they tell me how they feel?
  • Are my children misbehaving more that usual?
  • Do we seem unable to enjoy being together as a family?
  • Are we fighting among ourselves more often?
  • Are my children backsliding in their development? (For example, having more difficulty leaving you, maintaining toilet training, being unable to play by him or herself or being unusually dependent on you.)
  • Is my family able to accept help from others?
  • Do I resent it that other people seem happy?
  • Do I feel angry that others don't have this burden to deal with?
  • Are my constant feelings of sadness or anxiety affecting the people I care about?
  • Are financial or insurance problems getting in the way of dealing with the situation?
  • Am I or my partner less interested in sexual intimacy?
  • Do my family members have problems that are making it more difficult for me to cope?

 When to consider a support group

The Social Work Services department offers a variety of group programs. Some meet in the evenings and others during the day. Some are open to everyone with different diagnoses while others are composed of the same people, dealing with the same diagnosis or age group, for instance. If we don't have a group that seems to meet your needs, we will try to start one if enough people are interested or find you one in your community.

The purpose of a support group is to help people share their concerns with one another and to learn new ways of tackling problems. Participants can expect to learn more about the disease itself in addition to getting new ideas from other group members. For instance, a woman with breast cancer can learn from other women about breast reconstruction. Young adults can hear how others have approached problems with dating.

Support groups for people with cancer can be organized in several different ways. Open-ended groups are set up to allow anyone with cancer or their family members to attend as many sessions as they find helpful. Or people might attend during periods when the course of the illness is changing or new decisions need to be made.

Closed groups are those in which the same people agree to meet for a set period of time, like for six or eight sessions. They can be organized in a number of ways like for people with the same diagnosis, the same sex or age range, the same stage of disease, or by the kind of treatment people are getting. Our group for people with esophageal cancer is one example.

Groups can be organized by topic, meaning different issues will be discussed each week or they can have a free-flowing agenda where participants can discuss whatever comes up. Regardless of the kind of group you attend, confidentiality should always be discussed. You should feel free to discuss your concerns with others and know that what is discussed will remain confidential among group members.

 What kind of group should I attend?

Sometimes people wonder if they should attend a group organized by a professional or by a cancer survivor. Professionals include oncology social workers or nurses, psychologists, psychiatrists, or clergy. Professionals should be licensed and have skills in group "facilitation". This means they will have had training in how to go about setting up a group and how to help members get their needs met. This is the case with Fox Chase staff. Professionals also know how to deal with difficult group members. Examples might be someone who is so upset that they take over the conversation or are unable to listen to the worries of others. Professionals are able to deal with these issues.

People may have strong feelings about the kind of group that they want. Some will feel that only someone who has "been there" will make a good group leader. Others want a professional who might be able to offer more education about cancer or emotional issues. Professional facilitators are available at Fox Chase and groups run by cancer survivors may be available in your own community. You might consider trying both types of groups to figure out what type is right for you. Your "comfort level" is usually a good sign that you have found the right group for you. If you feel comfortable sharing your experiences and are better able to address your problems, the group will probably be helpful. If not, consider another group or another kind of counseling until you figure out what is best for you or your family.

What if I'm worried that a group will be too depressing?

Some people are more comfortable in groups than others. It may be easy to imagine sharing your feelings with others or it could seem like a real assault on your privacy. There are few "rights or wrongs" about how people feel about participating in a group. Some people find them very useful at the point of diagnosis or changes in treatment. Patients with more experience with cancer can help new patients know what to expect and avoid troublesome situations. If you don't know if a group is right for you, we will try to help you figure that out.

Sometimes people don't want to attend a support group because they think that it will be "too depressing" to listen to other peoples' problems. This does happen occasionally but for the most part, patients are very good at helping a discouraged group member feel better. Everyone has down times - the trick is to figure out how to stop the negative thinking from taking over. It's all too easy to imagine the worst. Other patients have "been there" and can offer the kind of encouragement and even 'inspiration' to keep fighting when times are tough. Sometimes new group members are surprised at how much humor is expressed in a support group. Finding something funny in a situation is a very good way of moving past a difficult time.

It may take time to determine how much of yourself to share with others. Some group members will be very talkative while others learn better just by listening. Usually, group members will gradually feel more comfortable in discussing their concerns and will get satisfaction from helping others in the group.

Does everyone benefit from attending a support group?

Sometimes patients will experience pressure from family or friends about attending a support group. This happens because people often don't feel comfortable talking about cancer. They think that they have to say something to "fix" the problem or to help you to feel better, when really they just need to listen. The nature of your needs should help you decide whether to try a support group. Some needs lend themselves to being addressed in a support group. Examples are the need for information, such as how children typically react to a parent's diagnosis, how to explain your diagnosis at work, or how to communicate better with your doctor. Other problems, such as severe marital or emotional problems, may seem too "private" or complicated to share with others.

The intensity of your feelings about a situation will also help you to decide about attending a group. You may feel so upset about your situation that the idea of discussing it with others makes it worse. Your own distress may make it impossible to listen to the problems of others. In this kind of situation, an individual counselor can concentrate on you and help you to feel better more quickly. Once you feel less anxious or overwhelmed, you may be in a better position to benefit from a support group.

Occasionally, people dealing with serious medical problems get so desperate that they think about suicide. This is not a usual response to having cancer but can happen to people who may have other stresses in their lives in addition to the cancer. Sometimes people can feel so hopeless that they can't imagine how the situation will ever get better. If this is how you or a family member is feeling, you need immediate help. This is not the kind of situation that joining a support group will help. A psychiatrist should be consulted who can evaluate how serious the situation is the severity of the situation and prescribe medications if necessary.