23 October 2017
Monday 16 October marked the launch of Cancer Council SA’s partnership with Flinders University and Flinders Foundation in rolling out Finding My Way, a six-week, web-based program structured to help people manage common psychosocial concerns associated with early-stage cancer diagnosis. Lisa Beatty, Clinical Psychologist and Cancer Council SA Postdoctoral Fellow (Cancer Support) at the Flinders Centre for Innovation in Cancer, shares her reasons for developing this program.
We know that while up to 40 per cent of people experience elevated distress following a cancer diagnosis, fewer than 20 per cent of these people choose to attend existing or available mental health services. This statistic tells us of a widespread problem: that there are people out there in need of support who cannot, do not want to, or don’t know about how they can access our help.
Who is it for?
I authored Finding My Way to cater directly for these people who were slipping through the cracks of traditional support services. We sought to work around the identified barriers of geography (including rural or remote living) and resource accessibility (including long waitlists and financial strain) by providing evidence-based strategies that assist people to cope with the stress of their cancer diagnosis from the comfort and privacy of their own homes, and with the benefit of convenience, in that they can work through the program in their own time and at their own pace. There is also the notion that face-to-face therapy isn’t for everyone, and that to have the most significant impact, we need to diversify how we approach support. It acknowledges that everyone experiences their diagnosis differently, and provides an alternative support system to increase the number of people we can reach.
How is it structured?
The program is designed to be progressed through gradually, so people can access one topic each week or as needed, and they can rearrange the module order based on relevance to them. While we appreciate the individualised experience of diagnosis, the program has been structured around commonly shared themes, including the pragmatics of navigating an unfamiliar medical system, ongoing fluctuations of emotion, managing physical symptoms and side effects, dealing with shifting expectations, and maintaining or growing core support networks, to name a few.
Where did the idea come from?
Finding My Way is the result of collaboration between oncology and psychology clinicians, cancer consumers and advocacy bodies. This final program is the end product of 12 years of rigorous development and research, which started during my Clinical Psychology PhD. I developed two workbooks, one of which was adapted into an online platform and—following its initial success in a small study environment—was trialled across six hospitals supported by NHMRC funding. Our sample consisted of patients recently diagnosed (i.e. within the past 12 months) with a cancer being treated with ‘curative intent’, which included surgery, chemotherapy and radiotherapy. The key findings were that:
- Finding My Way improved two aspects of quality of life: overall/global quality of life, and emotional functioning—which is the ability to live with and manage distress so it has less of an impact on daily life.
- People who accessed Finding My Way had a reduced need to see other health services, particularly supportive-care practitioners, while they were actively using the program. Interestingly, six months later, they were seeking out more health services again, because they were no longer using our program so routinely.
As a clinical psychologist specialising in psycho-oncology (the scientific approach to understanding and reducing the psychological impact of cancer), I am passionate about improving the psychosocial (emotional, social, physical and mental) outcomes for those impacted by cancer. That, combined with the knowledge that over 85 per cent of Australians now have internet access and that people with cancer are increasingly internet-proficient, made my research pathway a logical one.
Finding My Way and further support
We like to think of Finding My Way as part of a ‘stepped care’ system, whereby the online platform acts as an entry point to future support-seeking behaviours. Any needs that are unmet after completion of the program would then be addressed via phone or face-to-face means. This helps to perhaps free up the face-to-face services for those who have the highest or most urgent need, while also providing a good resource to people who may otherwise completely opt out of psychosocial care. The internet won’t ever fully replace traditional face-to-face care; it simply provides an avenue for increasing the reach in a cost effective way – we can get resources out to more people who otherwise would be missed.
Finding My Way can complement existing support services, including the 13 11 20 Cancer Council telephone service and face-to-face counselling, referral to a private community psychologist via the Medicare Better Access scheme, and many treating oncology centres will have a social work, counselling or psychosocial oncology service. It is about the individual having access to a number of support avenues, so that they can have the choice to design a support system which best suits them.
What’s next on the horizon?
While we are looking to adapt the program to cater for people with advanced or incurable cancer, Finding My Way is not a recommended resource for these people at present. I think the scope and need for providing online resources to those who may be physically too unwell, or limited, to attend face-to-face therapy is huge. We live in an economic climate where the pressure on existing health system resources is so high that we have to think outside the square, otherwise we do a disservice to those who need it most.
Feel free to check out Finding My Way if you have some of the concerns that we’ve discussed here; you can have a read through some resources it provides as a starting point, before deciding what to do next.
PhD (Clin Psych)
Cancer Council SA Postdoctoral Fellow (Cancer Support)
Flinders Centre for Innovation in Cancer
College of Medicine & Public Health