Adjustment to cancer - coping or personal transition?

The term 'adjustment' is widely used within the psycho-oncology literature and, although it is a topic of central importance to the lived experience of people with cancer, the psychological mechanisms of adjustment have rarely been described. Rather than regarding it as the absence of psychopathology or the end-point of coping with the global threat of cancer, adjustment refers to the psychological processes that occur over time as the individual, and those in their social world, manage, learn from and adapt to the multitude of changes which have been precipitated by the illness and its treatment. However, these changes are not always for the worse: sometimes they precipitate 'healthy personal growth' in a number of areas. It is only from explicit theories of adjustment that progress can be made in understanding how and why psychological disorders so frequently develop in cancer and what steps may be taken to prevent them. This paper combines the complementary assets of coping theory and social-cognitive theory and proposes the Social-Cognitive Transition (SCT) model of adjustment, a clinical model which also accounts for the frequent reports of healthy personal growth associated with cancer. Copyright 2001 John Wiley & Sons, Ltd.