The Health Professionals Guide to Delivering Psychological Care for Men with Prostate Cancer

Suzanne K Chambers AO, PhD, Nicole Heneka, PhD, Jeff Dunn AO, PhD

A Facing the Tiger
Psychological Care Resource

This Australian-developed manual helps health professionals working with men with prostate cancer achieve better patient care and survivorship through psychological support. It gives evidence-based guidelines and practical advice on how to provide timely men-centred psychological care within a professional’s existing position and capabilities.

Worldwide, millions of men are living with a diagnosis of prostate cancer. Their survival rates are high because of medical advances such as robot-assisted surgeries, targeted radiation therapy, hormone-blocking treatments, new chemotherapy regimes and genomic profiling.

Yet compared with the general population, men with prostate cancer are twice as likely to experience depression and three times more likely to experience anxiety. They have a 70% greater risk of suicide. Their distress is often hidden as many men are reluctant to ask for psychological help or admit to significant personal difficulties.

Research shows that the nurses, doctors, and allied health professionals who treat and care for men with prostate cancer report the experience as challenging and uncoordinated. Patient care provision is fragmented, under-resourced, and often distressing. Health professionals continue to experience significant stress levels in routine prostate cancer patient care.

The Health Professionals Guide to Delivering Psychological Care for Men With Prostate Cancer shows how and when to explore psychological issues with prostate cancer patients through structured support sessions to match their needs throughout treatment and care. Flexible components outline guidelines for discussions with men and their partners and facilitate regular use of distress monitoring and survivorship care plans. The Guide uses the Facing the Tiger self-help patient book as its accompanying resource. For the minority of patients who exhibit major clinical levels of distress under treatment, the Guide explains how to detect this and when to refer them to specialised treatment.

The Guide is used within multidisciplinary treatment centres that provide medical, nursing and allied support services to prostate cancer patients. Most commonly, it is used by prostate cancer care nurses or urology and oncology nurses, but it can also be used by psychologists, occupational therapists, psychiatrists, social workers, physiotherapists, exercise physiologists, sex therapists, surgeons, or general practitioners.

The Guide includes:

  • flexible session structure guidelines
  • patient self-management resource Facing the Tiger as an Appendix
  • downloadable patient worksheets
  • a downloadable fill-in PDF patient survivorship care plan
  • download links to free external forms/tests
  • external resource list covering issues such as sex, urinary problems, exercise and complementary medicine.

Training for Health Professionals

While not essential for use, a training workshop for health professionals who have knowledge and experience working with people with cancer is available. Guidance is provided around vigilance and surveillance of psychological well-being 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.

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About the Author

Professor Suzanne K Chambers AO, PhD
Professor Chambers AO is a health psychologist and registered nurse who has been working as a practitioner-researcher in psycho-oncology for over 30 years. She was awarded her PhD in 2004 within the School of Psychology at Griffith University and has over 300 peer-reviewed publications and numerous books, book chapters and monographs. Her work has focussed on developing models to predict help-seeking and adjustment after cancer: designing remote access psychological interventions for people affected by cancer, integrating peer support into controlled design methodologies, and integrating distress screening into interventions to target high distress cancer patient groups. Professor Chambers was appointed an Officer in the General Division of the Order of Australia (AO) in 2018 for distinguished service to medical research, particularly in the area of psycho-oncology and to community health through patient care strategies to assist men with prostate cancer. She is a Board member of Health Male (Andrology Australia). Professor Chambers is Executive Dean of the Faculty of Health Sciences at the Australian Catholic University.

Dr Nicole Heneka, PhD
Dr Heneka is a Postdoctoral Research Fellow with the National Health and Medical Research Council Centre for Research Excellence in Prostate Cancer Survivorship at the University of Technology Sydney. She has over 20 years of experience in program management and has focussed on health services research in cancer and palliative care services for the last 12 years. In her current role, she leads a program of research in the delivery of prostate cancer survivorship care, including patterns of care, implementation and evaluation strategies for survivorship care, and research capacity building in survivorship care. Dr Heneka’s work in health services research has been recognised through her award of the Clinical Excellence Commission Ian O’Rourke Scholarship in Patient Safety (2016) and the Palliative Care Australia, National Emerging Researcher award (2019).

Professor Jeff Dunn AO, PhD
Professor Jeff Dunn AO is the CEO of Prostate Cancer Foundation of Australia and President-Elect of the Union for International Cancer Control (UICC). His work in cancer control spans 30 years, during which time he has dedicated his career to the development of strategies that underpin cancer survival and improve awareness of the disease. He is a recognised World Cancer Leader and, prior to his appointment as UICC President-Elect, served as Treasurer of the UICC for four years and as an Elected Director for six. Professor Dunn also serves as the Professor and Chair of Social and Behavioural Science at the University of Southern Queensland, where his work has a central focus on the social and behavioural aspects of cancer, covering the continuum of research, prevention, early detection, supportive care, and quality of life. He is actively involved in research in this field and is also a Director of the West Moreton Hospital and Health Service Board and Chair of the Risk and Audit Committee. He holds an appointment as an Officer in the Order of Australia (2014) for distinguished service to medical administration through the leadership of cancer control organisations and promotion of innovative and integrated cancer care programs.

Table of Contents

Chapter 1

Understanding the Facing the Tiger Psychological Care Approach


Chapter 2

Building a Facing the Tiger Intervention


Chapter 3

The Foundation Components of a Facing the Tiger Intervention


Chapter 4

Flexible Component 1: Psychoeducation — Coping with a Prostate Cancer Diagnosis


Chapter 5

Flexible Component 2: Stress Management and Wellbeing


Chapter 6

Flexible Component 3: Treatment Decision Making


Chapter 7

Flexible Component 4: Managing Relationships Under Stress


Chapter 8

Flexible Component 5: Problem Solving


Chapter 9

Flexible Component 6: Managing Difficult Thoughts


Chapter 10

Flexible Component 7: Pivoting to Valued Directions


Chapter 11

Flexible Component 8: Masculinity and Prostate Cancer


Chapter 12

Flexible Component 9: Prostate Cancer and Sexual Relationships


Chapter 13

Flexible Component 10: Survivorship Care




Appendix 1: Resources

Helpful Information


Appendix 2: Client Handouts

Appendix 2.1 Tiger Activity Handout 1 — Awareness of Responses to Stress and Coping Strategies

Appendix 2.2 Tiger Activity Handout 2 — Goal Setting

Appendix 2.3 Tiger Relaxation Handout

Appendix 2.4 Tiger Activity Handout 3 — Mindfulness Focussing

Appendix 2.5 Tiger Activity Handout 4 — Goal Setting to De-stress

Appendix 2.6 Tiger Activity Handout 5 — Treatment Decision Making

Appendix 2.7 Tiger Activity Handout 6 — Problem Solving

Appendix 2.8 Tiger Activity Handout 7 — Automatic Thinking

Appendix 2.9 Tiger Activity Handout 8 — Identifying Patterns of Thinking

Appendix 2.10 Tiger Activity Handout 9 — Getting Unstuck

Appendix 2.11 Worksheet: Masculinity in Health Inventory

Appendix 2.12 Tiger Activity Handout 10 — Getting Sex Back on Track


Appendix 3: Prostate Cancer Distress Screen          


Appendix 4: Prostate Cancer Survivorship Care Plan


Appendix 5: Patient Screening Tools


Appendix 6: Facing the Tiger: A Survivorship Guide for Men with Prostate Cancer and their Partners