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While conducting an initial assessment, we at CancerCare take into consideration that the person on the other side of the phone is not only vulnerable due to the nature of the questions we are asking, but understand that they are possibly experiencing a crisis situation. Two things are unique to an initial assessment of an oncology patient. First, the patient is likely on edge, anxious, or troubled due to the crisis at hand. Second, despite the patient’s current crisis, flexibility and openmindedness are needed because any needs and therapy goals discussed during an initial assessment are likely to change over time.

Everyone defines crisis differently, and we cannot expect any 2 people to handle the same situation exactly the same; thus we try to learn how the patient has previously handled stressors. This will provide clues to the patient’s coping mechanisms as well as social supports and allow the patient a chance to feel empowered. Whether coping with an initial diagnosis, a fear of recurrence, or even the transition from acute care to survivorship, the patient can feel strong enough to face the challenge. We take extra care during this assessment so the client feels comfortable talking with us and opens up so as to get as accurate an assessment as possible.

Cancer does not just affect the person with the diagnosis; it affects the entire family as well. We should consider the entire family as the patient so the sociocultural dynamics within the family and what role these have in the client’s coping skills are included in our assessment. The initial phone call might not be for counseling at all, but instead from a caregiver seeking financial assistance for their loved one. By showing genuine empathy towards family members and what they are going through, we could be opening a door for them to consider counseling.

The therapeutic alliance is built from moment the phone is picked up because we are never sure who we will be speaking with or what they are experiencing. CancerCare provides a consistently nurturing place that allows those who call to have a safe space to be heard. For those who have been touched by cancer, this is genuinely irreplaceable.


1. Christ G, Messner C, Behar L, eds. Handbook of Oncology Social Work: Psychosocial Care for People with Cancer. New York, NY: Oxford University Press; 2015.