Background
Normal development in adolescence and young adulthood (AYA) incorporates multiple transitions, including physical, cognitive, emotional, sexual and identity. A cancer diagnosis brings additional challenges unique to this developmental stage, with AYA cancer survivors particularly vulnerable to disruption to their developing identity.
With improving survival rates, AYA spend decades as cancer survivors negotiating many physical and psychosocial consequences. Despite growing identification of medical and psychosocial needs, less is known about how to support AYA through this period.
Psychologists are uniquely positioned to provide therapeutic benefit to AYA experiencing post-treatment identity disruption, support continued healthy development, and facilitate mental health into adulthood.
Aim
To describe the role of psychology within an AYA Oncology Service in supporting AYA cancer survivors to negotiate identity challenges, and promote continued health and wellbeing into adulthood, illustrated by case examples.
Discussion
Patients with identity concerns in survivorship benefit from longer-term, integrative psychotherapy. This enables AYA to utilise the therapeutic relationship to process and find meaning in their experience, and to negotiate conflict between their pre-morbid sense of identity and evolving self-view.
Case 1:
24-year-old woman three months post Hodgkin’s Lymphoma treatment. Psychotherapy over fourteen months supported navigation of conflict between pre-morbid identification with career advancement, and subsequent focus on health goals. Consistency of the therapeutic relationship provided a base for safe exploration of increasingly balanced and integrated identity, and associated reduction of anxiety.
Case 2:
25-year-old man six years after treatment for multiple osteosarcoma relapses, with extensive treatment throughout middle-late adolescence causing significant developmental disruption. Psychotherapy over 7 months provided a safe therapeutic space to resume identity exploration and recommence normative developmental tasks typically achieved at a younger age.
Outcomes
Implications for clinical practice include a need for greater recognition of psychological consequences after cancer, and providing psychological support to facilitate continued healthy identity development.