Abstract
Abstract Objective: The purpose of this mixed methods study was to examine what factors may influence emotional suppression and emotional expression in breast cancer patients and how coping styles relate to beliefs about physician-driven referrals to therapy during the cancer treatment process to improve quality of life during and after breast cancer treatment. Methods: A mixed method research design consisting of quantitative methods including a demographics survey, the Courtauld Emotional Control Scale and treatment preference questionnaires followed by optional participation in a semi-structured interview. Sixty-nine participants who met the inclusion criteria were selected as the quantitative study sample and 27 participated in interviews to further discuss their personal views on therapy during breast cancer treatment, beliefs about physician-driven referrals and experiences of coping throughout and post-cancer treatment. Results: Demographic variables including age, marital status, income, and experience of psychotherapy prior to breast cancer diagnosis are statically significant factors that influence CECS scores and coping styles. Thematic narrative analysis of interviews revealed both Expressers and Suppressors recounted experiencing the ‘Elsa effect’, a term coined to describe emotional concealment as a form of emotionally protecting self and others and reported that a physician driven referral to therapy would have been helpful in terms with coping and improving quality of life. Participants universally believed that there should be some level of psychotherapy referrals for supportive mental health care during and after the treatment process. Types of supports to which they wanted to be referred, how referrals are made, why referrals are needed, language used when making referrals, what medium through which therapeutic support should be offered, and whether or not therapy referrals should be mandated were all discussed. Physician stigma related to psychotherapy was also suggested as a possible barrier. Conclusions: Overwhelmingly, participants who fell into either category of emotional suppressor or emotional expresser believed that there should be physician driven referrals to therapy during the breast cancer treatment process as part of best practices for improved quality of life. Both those identified as suppressors and expressers indicated high rates of concealing one’s true emotional experience. This highlights the need for psychological therapy referrals to be integrated as a best practice, regardless of patient’s identified coping style or demographic identities. Referral sources should be mindful of language used, patient ability to access to services and other factors as part of the referral process. Citation Format: Joyce Williams, Beth Counselman-Carpenter, William Burak. Breast cancer patient perspectives on the need for psychotherapy and the roll of physician referrals for improved quality of life during and post treatment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-11-04.