By Aleksandra Vujicic

Communications Coordinator, Department of Psychiatry

A University of Iowa Psychiatry Professor who has devoted 30 years to studying and using Cognitive Behavior Therapy (CBT) to treat patients with depression and a number of other mental health issues, is now applying the therapy to help cancer patients going through a wide range of experiences, from being initially diagnosed to facing end-of-life concerns.

Scott Temple, PhD, a Clinical Professor and Director of Psychosocial Treatments in the UI Department of Psychiatry, has released Brief Cognitive Behavior Therapy for Cancer Patients: Re-Visioning the CBT Paradigm to serve as a guide for clinicians working specifically with this medically ill group.

The book introduces a new organizing model for CBT that combines the original therapy, created by Aaron Beck at the University of Pennsylvania, with newer developments in the field.  The model includes eight organizing principles for modern CBT.  The overall model is a general one for CBT; but the specific applications in the book are for cancer patients.

“It’s intended to provide a balance of science, theory and practical applications for the clinician, so that they can work with people who are going through all phases and aspects of cancer,” Temple said. 

Temple has seen many patients benefit rapidly from CBT, even outside of the psychiatry clinic. He collaborates with the Supportive and Palliative care team at the UI where he sees cancer patients several times a week.

“They are often average everyday folks, and it’s been a tremendous blessing to see how the tools and techniques of cognitive behavioral therapy can help people who don’t necessarily have a mental illness,” he said.

In the book, Temple shares the story of a 41-year-old woman, a writer, poet, and professor, who was diagnosed with breast cancer. She said she felt fearful, worried and alone after receiving her diagnosis, but she had never seen a psychologist before.

“She was especially distressed at night, when it was dark, her husband was asleep, and she was alone in their bed with her fears and worries,” Temple writes. “It appeared that her beliefs about being a burden, and about intruding on her husband’s need for rest, were keeping her from turning to a key source of support and soothing in her moments of greatest need.”

At her first session, the woman addressed her fear of being a burden and even imagined her husband’s reaction if he were to know she was suffering late at night.

“He’d say to wake him up, if I needed to,” she said, adding that her husband might even be upset if he found out she didn’t ask him for help.

After this realization, the woman agreed to tell her husband about her need for comfort during the late night hours, employing a strategy used in CBT that focuses on connecting people to sources of soothing and support from others.

“In the meantime, the social support and the physical soothing from her husband at night were sufficient to bring palpable relief to her in her dark night of the soul,” Temple writes.

The book, released February 4, has already received praise from scholars in both the psychosocial and cancer fields.

“His expert advice is rooted in modern CBT and delivered in a compassionate and engaging style. This makes it an important, much needed, and enduring contribution to the literature,” writes Stefan Hofmann, professor of psychological and brain sciences at Boston University.

CBT is built on the assumption that a person’s interpretation of a certain experience influences their mood or behavior, more than the experience itself. Beck’s model focuses on identifying common distortions in thinking that people with certain mental illnesses share and on working to help them change those thoughts. 

Temple says CBT has grown vastly over the past three decades and there are now a number of different forms and practices. His book outlines eight principles to help organize the evolving model, which is explained both by theory and case examples.

One principle he discusses is the balance between acceptance and change.

“When I work with cancer patients, they can’t change having cancer and one of the things that’s very vital, from a very heartfelt place, is helping people deeply accept the hand of cards that they have,” he said.

Temple hopes to take the therapy a step further and apply it to the general population--to average people who may be dealing with divorce or job loss. He says it’s already time to start working on his next book to help them deal with the tough times.

“The diagnosis of cancer is only one of them. There are all kinds of occasions in the human life where we have opportunities to either have our lives fall apart or pull together,” he said.