Although chemotherapy is one of the important pillars of the treatment of many types of cancer, it can simultaneously create a series of physical and psychological pressures for the patient. Being in repeated cycles of treatment, waiting for the results of tests, worrying about the effectiveness of the treatment, complications such as nausea, fatigue, pain, changes in appetite and sleep, changes in body image, and worrying about the future can lead to increased psychological distress or distress . In this situation, anxiety and depression may also manifest independently or in conjunction with Distress , affecting the quality of life, family relationships, participation in treatment, and the patient's ability to adapt to the disease. From this perspective, in psycho-oncology, short-term psychological interventions have been considered as one of the practical approaches to identify and reduce these problems, as many patients undergoing chemotherapy are unable to participate in long-term psychotherapy programs due to fatigue, time constraints, physical condition, or a stressful treatment program.
Short-term psychological interventions are typically designed with the aim of reducing the severity of symptoms, enhancing coping skills, and helping the patient manage the predictable pressures of the course of treatment. Unlike long-term psychotherapies that may focus on deep personality patterns or long-standing conflicts, short-term interventions in the context of cancer focus more on the patient's current needs and problems related to the disease. Anxiety management, emotion regulation, cognitive restructuring, relaxation training, problem-solving, strengthening social support, teaching coping skills, and creating a sense of control are some of the components that can be used in these programs. The main goal of these interventions is not to eliminate all of a patient's normal reactions to cancer, but to help the patient manage the difficult emotions and pressures of treatment in a more adaptive way.
Distress in patients undergoing chemotherapy is a multidimensional phenomenon and is not limited to anxiety or depression alone. The patient may be contemporaneous with emotional worries, financial problems, disruption in family roles, job difficulties, worries about child care, changing social relationships, and uncertainty about the future. Therefore, short-term interventions will be more effective if they consider Distress as a multidimensional experience. For example, training in relaxation techniques may reduce physiological anxiety, but if the main cause of the patient's distress is economic problems or a lack of family support, the intervention should also address the identification and resolution of social and practical sources of stress in addition to emotion management.
From a theoretical perspective, one of the important mechanisms of effectiveness of short-term interventions is to increase the patient's sense of control and self-efficacy. Cancer and chemotherapy can reduce a person's sense of control over their body, life plan, and future. The patient may feel that important events in their life are happening outside of their control. Psychological interventions can increase feelings of adequacy and self-efficacy by teaching actionable skills, helping to set short-term goals, and focusing on controllable areas. When the patient feels that they can manage some of their emotional reactions, sleep, communication, and daily behaviors, the likelihood of a decrease in helplessness and distress increases.
Short-term cognitive-behavioral interventions are one of the approaches that can be used in this field. In this approach, dysfunctional thoughts related to cancer are identified and evaluated, and the patient learns to distinguish between probability, possibility, and certainty. For example, the definitive expectation of treatment failure, the catastrophic prediction of the future, or the interpretation of any physical symptom as a sign that the cancer is progressing can exacerbate anxiety. Cognitive restructuring helps the patient examine these thoughts and develop more realistic and tolerant interpretations. This process does not mean compulsive positivity or denial of the risk of the disease, but rather aims to reduce cognitive errors and strike a balance between accepting reality and being able to continue living in the current situation.
Emotion regulation skills training can also be an important part of short-term interventions. The patient may experience waves of fear, anger, sadness, or frustration during chemotherapy. Emotion recognition training, emotional experience acceptance, controlled breathing, muscle relaxation, and distress tolerance skills can reduce the intensity of emotional reactions. Mindfulness attention skills training can also help the patient return their attention to the experience of the present moment rather than constantly grappling with an uncertain future. Such skills can be especially useful in situations such as waiting for medication to be injected, receiving test results, or facing treatment complications.
Research evidence in the field of psycho-oncology suggests that psychological interventions can be effective in reducing the distress, anxiety, and some depressive symptoms of cancer patients, although the level of effectiveness varies based on the type of intervention, the initial severity of symptoms, the type of cancer, the stage of the disease, the treatment conditions, and individual characteristics. Cognition and behavior-based interventions, coping skills training, supportive interventions, relaxation techniques, and some mindfulness-based interventions have been studied in different studies. Overall, the findings support the view that providing targeted psychological support can reduce part of the psychological burden of cancer treatment, but not all patients respond the same and the intervention should be tailored to individual needs.
One of the important advantages of short-term interventions is the possibility of integrating them into cancer treatment settings. Sessions can be delivered in the interval before chemotherapy, in the day treatment department, or in the form of online and telephone sessions. This feature allows the patient to receive psychological services without seriously disrupting the treatment plan. Even short multi-session interventions can provide the patient with skills that can later be used independently. In this sense, the goal of short-term intervention is not only to reduce symptoms while the patient is with the therapist, but also to develop a set of self-management skills to continue on the course of treatment.
The link between distress, anxiety, and depression is also important. The three concepts have overlaps, but they are not the same. Distress is a broader concept that can encompass a range of emotional, social, and practical problems, while anxiety and depression have more clinically specific patterns. As a result, reducing distress does not necessarily mean complete resolution of depression or anxiety disorder. Early screening can help identify patients whose symptoms go beyond the normal distress caused by the illness and require a more specialized evaluation. In severe cases, short-term psychological intervention may be placed alongside psychiatric or medical treatment and should not replace essential treatments.
In terms of clinical application, it is best to assess the level of distress, anxiety, depression, sleep quality, social support, pain and severity of treatment complications before initiating the intervention. This evaluation allows the intervention plan to be designed based on the most important factor of stress. For a patient with severe predictive anxiety, anxiety management training and gradual exposure to frightening situations can be a priority. In a patient where symptoms of depression and passivity predominate, behavioral activation, reinforcement of meaningful activities, and restructuring of the daily routine become more important. In a patient where the main problem is loneliness and lack of support, the intervention should also focus on interpersonal communication and the activation of the support network.
An important challenge in the implementation of these interventions is the difference in the physical condition of the patients. A patient who is facing extreme fatigue, nausea, pain, or physical weakness may not be able to participate in long sessions or complex exercises. Therefore, short-term interventions should be flexible, simple, and commensurate with the patient's physical capacity. The timing of the session is also important, and it is best to coordinate the psychological schedule with the patient's chemotherapy time and energy status. The use of short exercises, relaxation audio files, written training, and remote follow-up can increase patient participation.
Another limitation relates to patient heterogeneity and differences in the type of cancer and treatment. Results from a specific group of patients may not be directly generalizable to all cancer patients. Some studies also have a short follow-up period and it is unclear how long the reduction in distress or anxiety lasts after the end of the intervention. Therefore, future studies should investigate medium- and long-term outcomes in addition to immediate assessment, and determine which components of the intervention play the most role in maintaining therapeutic effects.
To increase effectiveness, it is suggested that short-term interventions be designed based on the initial screening of Distress and not be administered equally for all patients. The use of a phased care model can mean that patients with low Distress benefit from basic education and support, patients with moderate Distress benefit from short-term psychological interventions, and patients with severe symptoms benefit from more specialized evaluation and more comprehensive treatment. Also Integration A psychologist and psycho-oncologist in the cancer treatment team can facilitate early identification of problems and appropriate referrals. Using digital tools to continuously monitor symptoms can also make it possible to identify sudden changes in psychological status.