Betsy A. Bates Freed is a 2011 graduate of the PsyD Program in Clinical Psychology at Antioch University, Santa Barbara.


cancer, work, occupational, work-related distress, psychological adjustment, quality of life, survivors, generativity, quantitative, questionnaire

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Cancer is an increasingly survivable disease that significantly impacts the ability of individuals to negotiate successfully the developmental task most distinctly affiliated with middle adulthood: creating meaning through achievement, creativity, and service. For many adults, these goals are accomplished through employment. When cancer intrudes, patients may be deprived of the ability to participate fully in the “generativity” that developmental psychologist Erik Erikson deemed essential to a healthy adulthood. In qualitative studies, patients’ narratives speak of many work-related losses — of routine, normality, economic stability, social connection, purpose, and identity. While psychosocial issues and quality of life are viewed with increasing importance within the literature on cancer, there appears to be a paucity of quantitative data on the work-related distress alluded to in these studies. Building on themes from qualitative literature and personal therapeutic encounters, a work distress survey was developed and administered to 74 adult patients treated for cancer at a community cancer center. A strong association was found between work-related distress and negative — but not positive — psychological adjustment to cancer. A cluster of items related to diminution of the structural functions of work — a means of organizing the day, staving off boredom, and providing individuals with a sense of normality — were most strongly associated with negative psychological adjustment to cancer in this study. Implications for future research, clinical practice, and occupational application are discussed. The electronic version of this dissertation is at OhioLink ETD Center,