Psychological support is delivered as part of the Prehab4Cancer programme using the NICE recommended “stepped care model”. 

All Prehab4Cancer exercise specialists have completed cancer rehab training and Sage and Thyme foundation level training in communicating with people who are worried, giving them the skills to notice distress, listen, empathise and encourage self-management & use of existing support networks.

Where the exercise specialist assesses that the patient has unmet mental health / psychological needs, they can:

  • Signpost to local Improving Access to Psychological Therapies (IAPT) service for either self-referral or referral via GP/clinical team
  • Liaise with clinical teams: CNS etc. for increased emotional support and onward referral to appropriate service i.e. psychology, AHPs. Link with HNAs + Macmillan.

Screening Assessments

Patients are assessed using the following measures:

  • EQ5D – general/simple QOL measure including anxiety, depression questions

  • EORTC QLQ-C30  – cancer specific QOL measure recommended by NHSE

  • WHODAS (World Health Organisation Disability Assessment Schedule)

  • Self-Efficacy Scale assessment as to patient’s confidence to exercise

The Prehab4Cancer programme design recognises many of the secondary symptoms that cancer patients experience related to their diagnosis and subsequent treatment including fatigue, low mood and the experience of anxiety. It builds on widely understood principles surrounding exercise positively contributing to the reduction of such secondary symptoms, particularly related to mental health, with the overall aim of providing holistic interventions to improve patient quality of life prior to, during and after treatment.

It is evident already from participant feedback how engagement in Prehab4Cancer improves patients’ mental health and wellbeing. Here are participant feedback quotes which illustrate this:

“having the support of the instructors has been great. They have really helped me relax and feel less stressed out.”

“When I’ve been feeling really low I can concentrate on my wellbeing at the gym – made me feel better about myself”.

“Mentally it has done us really well. It gets you out of the house. Seeing the same people in the group was good for me”.

“Going to the sessions gave me confidence and a purpose”

Stepped Care Model  (NICE 2004)

1 All the health and social care professionals Recognition of psychological needs Effective information giving compassionate communication and general psychological support
2 Health and social care professionals with additional expertise Screening for psychological distress Psychological techniques such as problem solving
3 Trained and accredited professional Assessed for psychological distress and diagnosis of some psychopathology Counselling and specific psychological interventions such as anxiety management and solution-focused therapy, delivered according to explicit theoretical framework
4 Mental health specialists Diagnosis of psychopathology Specialist psychological and psychiatric interventions such as psychotherapy, including cognitive behavioural therapy (CBT)

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