Depression

The Oncology Nursing Society has Putting Evidence into Practice (PEP) resources. One resource is about depression specifically for our cancer population.

Cognitive Behavioral interventions  (CB) are listed by the PEP reviewers as a recommendation for practice in treating depression in patients with cancer. CB interventions focus on helping a patient recognize and reframe thoughts, feelings, and behaviors that are negative or unhelpful to their healing. CB interventions are skills and techniques derived from Cognitive Behavioral Therapy, which is a psychotherapy.

Part of registered nursing scope of practice is to provide “health counseling and health teaching” which includes “identifying patterns of human responses to actual or potential health problems amenable to a nursing regimen“. A nursing regimen “may include preventative, restorative, and health-promotion activities“. Providing CB interventions can be incorporated into your nursing practice.

Here are 3 ways to add cognitive behavioral interventions to your practice:

1. Circle of Control – Do you remember attending a Relationship-based Care workshop? One thing that was discussed was the idea that we have things we can control, things we can influence, and things we can worry about. Our patients have those same thoughts. Helping our patients to set aside things they worry about and focus on what they can control is nursing practice.
2. Perception as Reality – Another concept introduced in Relationship-based care work is the idea that our perceptions help guide our reality. We can help our patients talk through what they are thinking/feeling and then offer another perspective. Sometimes that means listening to understand or providing more education.
3. Breathing – Deep cleansing breaths can help a patient move out of their primitive/survival brain and into their higher thinking brain. Being in or reacting from the primitive/survival brain means fighting, running away, or hiding. When a person is reacting from the higher brain, it means that reasoning can happen.