Breast Cancer Resource Center Savannah, GA USA

Research Publications – CSWE 2023

Council on Social Work Education, Annual Program Meeting, Atlanta, GA, October 2023

Voices of survivors: recommendations for working with breast cancer patients in a triple-demic world

Authors: Dr. Elisabeth Counselman-Carpenter, PhD, LCSW, Associate Professor Adelphi University, Joyce T Williams, Founder and President, Keepers of the Flame Foundation

Breast cancer is the most prevalent cancer in the world and is considered both human rights and a significant public health issue (Oluwasanu & Olopade 2020; Ilgun et al., 2021). Health care as a human right should include access to integrated medical-behavioral health treatment when battling cancer, particularly for womxn of color, who are more likely to be diagnosed with and die from breast cancer. Literature indicates a need for psychological interventions for patients during and after breast cancer treatment, yet few physicians make referrals to behavioral health providers during the process (Admiraal et al., 2020) particularly for those with historically and socially marginalized identities. Also vulnerable are breast cancer patients who present with emotionally suppressive coping strategies (Type C); individuals who appear fine and present as cooperative, non-argumentative, and suppress their own needs in favor of others, are at greatest risk for emotional distress post-treatment. Type C coping was particularly taxed during the COVID-19 lockdown and remains challenging during the ongoing pandemic.

Medical professionals should consider referring all newly diagnosed patients to a therapist/counselor and create opportunities throughout treatment for psychotherapeutic support, but often do not despite breast cancer patient’s candid sharing about the biggest barrier for accessing mental health support at diagnosis being their own inability to “handle one more thing” and make a therapy appointment for themselves and have specific recommendations for medical providers related to the timing of referral, type of treatment and suggestions for collaborative care but often do not feel heard.

This interactive workshop shares what it means to decolonize behavioral health care provision for breast cancer patients and shares findings from a mixed methods study of 69 womxn currently fighting/in remission from breast cancer and shares their perspectives on what clinicians need to know in order to provide authentic, trauma-informed and anti-oppressive therapeutic services during an ongoing worldwide pandemic. This study employed a sequential concurrent design in two phases and included both demographics-based analysis and semi-structured interviews about treatment, emotions, stressors, and opinions on therapy referrals throughout the breast cancer treatment process with specific suggestions on clinician identity, content and modality of services and the need for both trauma-informed and decolonized approaches to service provision. Participants will engage in small group discussion, clinical case examples and large group discussion related to the need for collaborative care offered at multiple points in the treatment process, and through multiple modalities based on the recommendations of those fighting breast cancer. Presenters will offer a trauma-informed anti-racist framework for mental health practitioners to utilize when supporting breast cancer patients in therapy and through other clinical services. Presenters will also provide psycho-education from a patient-centered perspective for clinicians who do not identify as cancer survivors on nuanced clinical needs related to the significant physical and psychological side effects of cancer treatment including the impact of ‘chemo’ brain, a stage IV diagnosis, types of surgery, treatment trigger points and chemically/surgically-induced menopause and discuss the impact of the COVID-19 pandemic on breast cancer testing, treatment, and emotional support.

Learning Objectives:

  • Examine the unique clinical needs of womxn currently in treatment for breast cancer, particularly those with socially and historically marginalized identities and provide psychoeducation on the nuanced treatment of breast cancer patients (i.e. the effects of chemo brain, stage IV) for clinicians who do not identify as cancer survivors.
  • Engage in case-based discussion of trauma-informed, affirmative and decolonized clinical strategies to support womxn who are undergoing or are in treatment for breast cancer.
  • Discuss structural barriers such as institutional gate-keeping, mental health referral stigma, the impact of COVID-19 and other identified challenges to accessing mental health services shared by breast cancer survivors

About the Presenters

Beth Counselman-Carpenter, PhD, LCSW, RPT-S is an Associate Professor of Social Work at Adelphi University. Her practice and research interests include understanding the role of PTG in decreasing barriers to service provision in social work and medical settings, particularly with the LGBTQIA+ community, online learning pedagogy and mental health service provision for breast cancer survivors. She has co-authored two books: ‘Working with Grief, & Traumatic Loss: Theory, Practice, Personal Reflection’ & ‘Self-care for Clinicians and Decolonizing Human Behavior: An Anti-Oppressive Reader’, and a third book coming out in October 2023 entitled Multidisciplinary Human Behavior in the Complex Social Environment: Decolonizing Social Work Practice and frequently contributes to peer reviewed journals. In addition to teaching, she maintains a small private practice and community DEI consultancy practice. Beth has a BA in Sociology from the University of Richmond, an MSW from New York University and a PhD from Adelphi University

Ms. Williams founded Keepers of the Flame after her own battle with breast cancer in 2017 at the age of 36. The mission of KoF is to shine light into the darkness, empowering breast cancer patients to weather breast cancer both physically and emotionally. Some of the projects of KoF include a 52 week podcast psychoeducation series for women undergoing treatment for breast cancer; a resilience curriculum with related videos and resources known as Making Lemonade; Reframing Beauty through Photography; hardship; peer-counseling support; and a large scale community fundraising and empowerment event called Shine the Light Disco Night. In June 2022, Keepers of the Flame became an incorporated 501(c)3 to continue the mission and to deepen research activities and community-based programs to support those fighting against breast cancer.