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Cognitive behavioural therapy in palliative and end-of-life car
  1. Samantha Dunlop
  1. Samantha Dunlop, at the time of writing, was working as a Clinical Nurse Specialist at Hospice in the Weald, Pembury, Kent. She is now a Macmillan Palliative Care Clinical Nurse Specialist, Maidstone and Tunbridge Wells NHS Trust. Email: samanthadunlop{at}


Anxiety and depression are often overlooked symptoms in patients with terminal conditions. There appears to be a link between anxiety and depression and a higher incidence of physical symptoms. Any psychological distress, whatever the cause, requires assessment and treatment. The role of counselling in palliative and end-of-life care (EoLC) is well established. Cognitive behavioural therapy (CBT) is a psychotherapeutic treatment tool that aims to enable individuals to change negative thought processes and behaviour. This article examines whether CBT can be adapted and utilised to reduce patients’ symptoms of low mood, anxiety and pain in the palliative care setting. CBT has the potential to be effective for this patient population, as it focuses on the ‘here and now’. Emerging evidence indicates that palliative care practitioners can be trained effectively to undertake CBT with their patients/clients. Nurses working with patients in palliative and EoLC settings should be familiar with CBT so that they can refer patients who might benefit to a practitioner competent in it use. Conflicts of interest: none

  • Behaviourism
  • Cognitive behavioural therapy
  • Palliative and end-of-life care
  • Symptom control
  • Terminal care

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