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This paper discusses how the concepts of hope and hopelessness can affect therapeutic interventions when working with people affected by cancer. The concepts of hope and hopelessness are considered within the therapeutic relationship and the biomedical model. This explores whether there is a difference between hope and denial and considers how culture, religion, and spirituality influence an individual's interpretation of hope. For some people living with a cancer diagnosis, the word ‘hope’ can become a burden. They can feel a pressure to present as strong, positive, and hopeful in the face of extremely confronting situations. Therapists need to give patients time and space to explore their feelings of hopelessness without rushing them to a place of hope for which they are not ready. Case examples are provided and the author reflects upon her own family therapy practice working in an acute health care facility. This stresses the importance of critical reflection, supervision, and peer support.
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