How it works

The Facing the Tiger Psychological Care Approach for prostate cancer can be applied in any prostate cancer treatment setting as either a basic intervention or at a higher tiered care level. It consists of three main components which can be flexibly applied:

The patient book is designed to be a first-off support, focusing on the day-to-day worries and concerns men and their partners experience when dealing with the disease. It makes use of cognitive behaviour therapy approaches, psycho-education and lived experience stories and encourages men and their partners to explore their own emotional and cognitive reactions to the disease, empowering them to find their strengths to deal effectively with life after a diagnosis. The book should be supplied to patients as soon as possible after diagnosis alongside standard medical information handouts and other support information. It can also be provided proactively to all patients no matter what stage of treatment (universal intervention) to help ease current distress which may be hidden and help prevent the development of higher levels of distress. It is particularly effective supplied to patients prior to major consultations when it allows them to process their thoughts and feelings before important discussions about treatment and side-effects. It should be provided to patients alongside the usual medical information handouts. The book is recognised as part of best-practice psychosocial care based on Australian guidelines for multidisciplinary treatment of prostate cancer and is endorsed by the Urological Society of Australia and New Zealand, the Australia and New Zealand Urological Nurses Society, and the Prostate Cancer Foundation of Australia (PCFA).

The healthcare provider manual is designed to be used particularly within multidisciplinary treatment centres that provide a level of medical, nursing and allied support services to prostate cancer patients. Most commonly, the manual is used by prostate cancer care nurses or urology and oncology nurses, but it can also be used by psychologists, occupational therapists, physiotherapists, exercise physiologists, sex therapists, or general practitioners. The manual allows the healthcare provider to structure tailored men-centred interventions to match the patient’s needs while ensuring consistent distress monitoring and encouraging the use of survivorship care plans. It uses existing information, stories, and activities in the patient book. The manual includes standardised session structure guidelines, flexible delivery options, downloadable and photocopiable session worksheets, a downloadable fill-in PDF patient survivorship care plan, download links to free external forms/tests and an external resource list covering issues such as sex, urinary problems, exercise and complementary medicine. No extra patient materials are required for an intervention to be conducted. In some Australian treatment centres selected staff may already be equipped to use the manual as all nurses in the PCFA Prostate Cancer Specialist Nursing Program are provided with a copy of the manual and receive training on its use with patients.

The training workshop is for health professionals who have knowledge and experience working with people with cancer. Guidance is provided around vigilance and surveillance of psychological wellbeing by incorporating screening for distress into the care model. The intervention strategies applied are informed by evidence on effective psychological care for men with prostate cancer, applying a cognitive behavioural approach and drawing from three main perspectives: stress and coping; problem-solving; and psychological flexibility. The workshop includes three core study elements that connect sequentially supported by the healthcare provider manual and a reflective learning Participant Training Workbook with set pre-reading. Small group learning cohorts (maximum of 20 participants) are utilised with a focus on connecting theory and evidence to practice. Remote and face-to-face delivery modes are available.

The result is that the Facing the Tiger Psychological Care Approach can be implemented within a medical setting without the need for extra staff or a large capital investment. Initial improvements in patient outcomes can be achieved quickly with universal intervention at a per patient cost of around AU$20.00 simply by supplying all patients with a copy of the self-help book. Extending that level of care to patients exhibiting higher levels of distress is achieved by equipping selected staff with the provider manual at AU$135.00 per professional. Optional training to enhance the effectiveness of using the manual and self-help book with patients costs around AU$500.00 per participant. The minority of patients who exhibit major clinical levels of distress under treatment can then be identified by this extended level of care and appropriately referred to outside psychological treatment.

For all enquiries about using Facing the Tiger in a cancer treatment centre or urology practice, please contact Stephen May,

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