Emotion-focused therapy for anxiety and depression in women with breast cancer

Emerging evidence supports the efficacy of transdiagnostic approaches in the treatment of comorbid conditions. Given that both depression and anxiety disorders have been consistently noted as the most common psychological presentation across site and stage of illness in patients with cancer, psycho-oncology as a specialty may benefit from approaches that implement transdiagnostic approaches to treatment. This paper presents an adaptation of emotion-focused therapy for comorbid anxiety and depression in women with breast cancer. It describes the activation of chronic problematic emotion schemes triggered by the experience of cancer and its medical treatment as well as their transformation through a sequence of emotional processing steps. Observed nuances in this specific case included existential triggers to emotional experience and mourning disenfranchised losses as part of grieving and letting go. A process of change occurs through overcoming emotional avoidance and demoralization, increasing distress tolerance, differentiation of core painful feelings, articulation of unmet needs; and generation of adaptive emotions such as boundary setting anger and self-compassion. Implications for practice in a cancer context are discussed in terms of case conceptualisation and therapeutic strategy. Further investment in the clinical development and research of emotion-focused therapy in psycho-oncology may prove informative and supportive in efforts to widen the evidence base and the choice of clinical treatment available to patients with cancer and comorbid anxiety and depressive disorders