1. The Lived Experiences of Breast and Prostate Cancer Patients and Their Partners Alison G. Wong, MA University of Connecticut Stephanie Trudeau-Hern, MS University of Minnesota Collaborative Family Healthcare Association 14 th Annual Conference October 4-6, 2012 Austin, Texas U.S.A. Session #B6 October 6, 2012

2. Faculty Disclosure We have not had any relevant financial relationships during the past 12 months.

3. Objectives Identify the research rationale and clinical benefits of medical family therapy in cancer care settings. Identify and address the physical, psychosocial, and relational issues faced by breast and prostate patients. Describe the self-of-the-practitioner challenges of various therapeutic issues such as transference and counter-transference, loss of client, and self care. Identify strategies to respond to the therapeutic challenges.

4. Agenda Theoretical background Issues facing couples coping with prostate and breast cancer Treatment approaches Self of the therapist issues

5. Illness can strike any family at any time. What is significant is at what point in life, in what form, and with what intensity they occur and how long they persist. Perhaps most important is how the experience of illness will psychosocially affect the entire family unit (Rolland, 1983)

6. The “We” Disease

7. Rolland’s Phase of Illness Developmental Tasks Crisis Phase – Life reorganization – Adaption – Flexibility Chronic Phase – Renegotiation of relationships – Uncertainty Terminal Phase – Anticipatory grief

8. Issues Facing Couples with Cancer Initial diagnosis During treatment Post-treatment Survival Recurrence Death and dying

9. Diagnosis Themes I can’t believe this is happening to me How bad is it? Am I going to live? Waiting for treatment to start. Patient and caregiver enter unspoken contract to focus on patient care. Therapeutic techniques Brief solution-focused therapy What things can you control? What kind of patient & caregiver do you want be?

10. Treatment Themes Treatment routine Medical family Partners Burnout Neglect of relationship starts to take a toll Therapeutic techniques Family of origin issues Short (30 min) sessions

11. Post-Treatment Themes What is my identity? Patient or survivor? Unknown and ambiguous Desire toward reorganization & reintegration Ok so back to normal, right? Therapeutic techniques Narrative therapy Experiential therapy

12. Survival Themes Major life changes Mourn loss of “old normal” What does it mean to be healthy? Recoupling: backburner couple issues move to the front burner Therapeutic techniques Narrative therapy Externalization of cancer

13. Recurrence Themes Yep, I knew the other shoe was going to drop Influenced by previous cancer experiences Therapeutic techniques Couple illness experience-directed Elicit the couple’s illness story

14. Death & Dying Themes Fears/beliefs around death Doing relationships on purpose Higher meaning, legacy, impact. Leaving nothing unsaid. Therapeutic techniques Narrative therapy Experiential therapy Construction of meaning

15. Other Issues Ambiguous loss Developmental issues Family lifecycle Gender Sexuality Body image Intimacy

16. Self of the MedFT Issues Family of origin issues Secondary trauma – Hyperawareness of illness Grief Isolation – Personal and professional Transference and counter-transference

17. “Nothing ever becomes real ‘til it is experienced.” - John Keats

18. Session Evaluation Please complete and return the evaluation form to the classroom monitor before leaving this session. Thank you!