The effect of psycho-oncological interventions on the feelings of guilt, helplessness, and emotional distress of caregivers of cancer patients is one of the important axes in family-centered psychological care, because family caregivers experience significant psychological and practical pressures during the process of diagnosis, treatment, complications of the disease, and long-term follow-up. Caring for a person with cancer may be accompanied by a strong sense of responsibility, worry about the future, fear of the worsening of the disease, fatigue, disruption in family roles, and reduced personal opportunities, and in some caregivers, it may lead to the formation of feelings of guilt, helplessness, and emotional distress. Feelings of guilt may arise when the caregiver thinks that they have not been sufficiently supportive of the patient, that they have not made the right decisions, that they have misbehaved in the past, or that they have been unable to control the course of the disease. Psychologically, many of these feelings arise from the distance between the caregiver's actual responsibility and the responsibility he or she has assumed in his or her mind. By carefully assessing these perceptions, the psycho-oncologist can help the caregiver distinguish between what is actually in his or her control and what is out of his or her control. One of the theoretical foundations of these interventions is the bio-psychosocial model, which considers the caregiver's distress as the result of the interaction of physical, cognitive, emotional, familial, and social factors. In this context, fatigue and lack of sleep can reduce emotional tolerance, increase catastrophic thoughts of anxiety, and the lack of social support can exacerbate feelings of loneliness and helplessness. The cognitive-behavioral approach also emphasizes the role of dysfunctional thoughts in the formation of feelings of guilt and powerlessness and helps the caregiver to identify and evaluate beliefs such as "I must always be strong" or "if the patient gets worse again, it is my fault."The goal of the intervention is not to eliminate the caregiver's responsibility, but to develop a realistic understanding of the limits of responsibility and his or her abilities. In the acceptance and commitment approach, the caregiver learns that the presence of feelings Guilt, fear, or helplessness does not necessarily mean that he or she is powerless, and he can act alongside these emotions based on his or her own values. Rather than trying to fully control unpleasant thoughts, this approach emphasizes psychological flexibility and the continuation of meaningful activities. Emotion regulation is also an important component of psychooncological interventions, helping the caregiver identify, name, and manage difficult emotions in an adaptive manner. The psycho-oncologist should assess the level of guilt, helplessness, anxiety, depression, fatigue, sleep disturbances, decreased social functioning, and pressure from the caregiver role in the initial evaluation. It is also necessary to determine whether the caregiver has withdrawn from their work, family, or social activities due to the intensity of care. One of the main applications of these interventions is psychological education about the nature of cancer and the limitations of human control over the course of the disease, as some caregivers think that with more care, they can control all the consequences of the disease. Correcting this perception can reduce the feelings of guilt caused by out-of-control outcomes. Problem-solving skills training also helps caregivers break down complex problems into smaller, manageable problems and find practical solutions to each problem. Communication skills are also particularly important, as the caregiver must be able to communicate their needs with the patient and other family members without feeling ashamed or guilty. The psycho-oncologist can emphasize building a family support network and dividing caring responsibilities so that the entire burden of care is not placed on one person's shoulders. Self-care education is also an integral part of this process, as a caregiver who does not pay attention to their sleep, nutrition, rest, social activity, and psychological needs may be exposed to burnout. In this context, self-care should not be seen as selfishness, but rather as part of maintaining one's caring capacity. Mindfulness-based interventions can help reduce mental engagement and increase focus on the present moment, allowing the caregiver to move away from the constant cycle of anticipating negative outcomes. Breathing and relaxation techniques can also be used to reduce physiological arousal and manage stressful situations. In cases where guilt is intense, it is important to investigate its origin, as sometimes true guilt is combined with false or unrealistic guilt and requires cognitive restructuring and emotional processing. In some cases, the caregiver may experience feelings of helplessness as a result of observing the patient's pain or suffering and think that there is nothing they can do to improve the situation. The psycho-oncologist can reinforce the caregiver's sense of agency by identifying real areas of control and shifting his attention from "controlling the outcome of the disease" to "controlling how he responds to the situation." Group interventions can also reduce caregivers' feelings of loneliness by providing an opportunity to share experiences and show them that many of their emotional reactions are observed among caregivers of cancer patients. However, group sessions should take into account individual differences and the varying severity of caregivers' problems. Peer support can be helpful, but it is not a substitute for specialist assessment and treatment in cases of severe distress. Collaboration between the psycho-oncist, doctor, nurse, and other members of the treatment team can also prevent the transmission of conflicting information and increase caregiver confusion. One of the main challenges is the concealment of distress by caregivers, as some of them consider the needs of the patient to be more important than their own, and postpone seeking psychological support. Another challenge is the guilt caused by inadequate care, which may exist even when the caregiver has done everything in their power to support the patient. Economic pressure, reduced income, time constraints, distance from health care facilities, and lack of family support can also limit the effectiveness of interventions. On the other hand, some caregivers may see asking for help as a sign of weakness due to family culture or social beliefs and may resist psychological intervention. Another limitation is that the caregiver's distress is not always caused by psychological factors alone, and the patient's medical problems, the severity of symptoms, the duration of treatment, and economic circumstances can play a decisive role. Therefore, psycho-oncological intervention should not be designed in such a way that all of the caregiver's problems are attributed to his/her individual characteristics. Effective interventions should consider family, social, and therapeutic resources in addition to individual skills. Regular screening of caregivers at different stages of the disease can allow for early detection of distress and prevent exacerbation of problems. In the presence of severe depression, severe anxiety, self-injurious thoughts, or serious dysfunction, a professional evaluation and, if necessary, a referral to a psychiatrist is necessary. Ultimately, the goal of psychooncological interventions is not to ensure that the caregiver never feels guilty, helpless, or sad, but rather that these emotions do not become a chronic and disruptive experience, and that the caregiver can maintain a sense of agency, self-esteem, effective communication, and the ability to take care of himself, along with the difficulty of the disease. Such an approach can transform patient care from an experience based on burnout and a sense of compulsion to a more humane, balanced, and supportive process, while at the same time considering the caregiver's place of mental health as one of the essential components of comprehensive cancer care.