A Clinical Case Study of Cognitive Behavior Therapy for Young Adult Cancer Survivors’ Psychological Distress: Utilizing the Generic Cognitive Model

Adolescents and young adults (AYAs) diagnosed with cancer often experience psychological distress that reflects the interaction of medical uncertainty, developmental disruption, and pre-existing cognitive and coping patterns. This clinical case study illustrates the use of cognitive behavior therapy (CBT), informed by the Generic Cognitive Model, with a 23-year-old young adult survivor of Hodgkin lymphoma experiencing anxiety, depressive symptoms, fear of cancer recurrence, avoidance, and difficulty re-engaging with academic and social goals after completing treatment. Case formulation emphasized the dynamic interaction among cancer-related triggers, beliefs about vulnerability and falling behind, heightened attentional focus on threat, and avoidance-based coping. Treatment consisted of eight structured CBT sessions targeting cognitive flexibility, attentional refocusing, behavioral activation, exposure to avoided activities, and relapse prevention. Across treatment, the client demonstrated clinically meaningful reductions in depressive symptoms, anxiety, and fear of cancer recurrence, alongside increased engagement in valued activities and improved tolerance of uncertainty. This case highlights the clinical utility of a formulation-driven CBT approach that neither minimizes the realities of cancer survivorship nor assumes that cancer is the sole cause of distress. Findings underscore the importance of attending to the post-treatment transition, surveillance-related anxiety, developmental concerns, and access pathways when providing psychosocial care for AYAs with cancer.