Group psychological therapy for cancer patients. A brief discussion of indications for its use, and the range of interventions available.

The growing evidence for the efficacy of psychological therapy in improving quality of life in cancer patients suggests that we should now consider it an adjuvant treatment in cancer management, analogous to adjuvant chemotherapy. If this is accepted, it follows that the main indication for advocating such adjuvant psychological therapy to patients should be an expert assessment that the patient is likely to benefit; it should not (as is usual at present) be restricted to either those patients with overt psychopathology, or those few who specifically request it. We describe five main kinds of therapy, arranging them on a hierarchy of increasingly active participation by the recipient, and noting the status of evidence for their efficacy. These five types are: providing information, emotional support, behavioral training in coping skills, psychotherapy (of various kinds), and, more speculatively, spiritual/existential therapy.