Insight into the integrative psycho-oncology program at Inova Life With Cancer

Photo Cred: Courtesy Photo/Inova Life With Cancer

By Bill Reddy, LAc, DiplAc

While waiting for credentialing as a new hire for the Inova Health System based in Falls Church, Virginia, I began introducing myself to the heads of various departments I would be working with. I came across Life with Cancer, located in Fairfax, where I met Michelle Ferretti, LCSW, OSW-C. 

Ferretti is a social worker specializing in oncology and is trained in qigong. She facilitates several free integrative programs at the Life with Cancer center, including tai chi and qigong. The building looks like a big single-family house and patients come and take part in acupuncture, art therapy, clinical psychotherapy, meditation, and mindfulness practice.

I sat down with Ferretti to learn more about the Life with Cancer program and what insights she has for practitioners providing integrative cancer care.

Integrative Practitioner: Can you tell me a little about yourself and the Life with Cancer program? 

Ferretti: I used to be a professional ballet dancer and was always curious about health and physical and emotional wellbeing. I studied massage therapy and medical qigong while I was dancing, and finally chose to pursue graduate studies in social work. I ended up getting a year-long internship with Inova’s Life with Cancer [program] six years ago and recently enrolled in the University of Michigan’s Integrative Oncology Scholars Program. As an oncology clinical therapist, I coordinate the Integrative Psycho-Oncology Program (IPOP), train IPOP facilitators, and provide outpatient counseling. I developed and currently facilitate a six-week introductory qigong class for patients and family members and helped develop a multidisciplinary program addressing cancer-related cognitive impairment.

At Life with Cancer, we provide a variety of integrative therapies, wellness programs, groups, and classes to patients and their families both during and after cancer treatment. These programs are mostly provided for free and include exercise programs, support groups, art therapy, tai chi, yoga, support for children and adolescents, nutrition, and a variety of education and emotional coping programs, as well as acupuncture, massage, and psycho-oncology.

Integrative Practitioner: Can you tell me about the IPOP program that Life with Cancer developed?

Ferretti: IPOP is a unique four-program curriculum, usually offered over about an eight-month period, designed to build emotional coping skills and resilience. Through the four programs, we use cognitive, mindfulness-based, and contemplative approaches. The four programs are designed to be taken in order, as one program builds on the next.

The first of the four programs, Mind Over Matter, was developed at Life with Cancer, and explores coping from a cognitive and values-driven perspective and lays the foundation for the second program, Mindfulness-Based Cancer Recovery (MBCR). In MBCR, participants learn how to manage emotions through mindfulness, meditation, and yoga. Compassion Cultivation Training follows MBCR, deepening the skills and exploring the relationship with the inner self through the lens of compassion. The curriculum concludes with Meaning Centered Psychotherapy, which helps integrate the experiences from the previous programs and focuses on creating, experiencing, and maintaining a sense of meaning in life, meaning that can be present during suffering and wellness.

Integrative Practitioner: What’s your experience of the IPOP program?

Ferretti: As a practitioner, the thing that I like most about IPOP is that there is time for people to explore the material and experiences at their own rate, time to be able to see growth and change. Not everybody comes to a conclusion or awareness at the same time; we all have our own individual process. 

The four programs in the curriculum build on each other, and use different lenses and tools, but they’re all focusing on emotional coping, connecting people to those internal tools and offering opportunities for them to try them out. These “internal tools,” as I call them, help people manage uncertainty and all the reactions uncertainty brings. For me, internal tools are breath, meditation, awareness of thoughts and physical experiences, compassion, and energy work, tools that once learned live with us.

In my mind, these tools, combined with our experience of getting through tough times in the past, are the foundation of our strength to know we can handle what comes. What drove me to social work, and to doing this kind of work, was the desire to help others connect to these tools, to their strength. Uncertainty is less scary if you can trust your ability to cope with whatever comes. By having this longer-term curriculum, we can allow space and time and invite a deeper and more experiential kind of learning, helping people connect to their tools and trust their strength. When I see people using these tools, or they are telling me a story of a time when maybe even they were surprised with how well they handled a situation, that’s very fulfilling for me.

Integrative Practitioner: Can you tell me about the group aspect of IPOP? 

Ferretti: I think there is something very specific that happens in a group setting, different than what can happen one on one. Both are valuable in my mind, but I think that there’s a shared vulnerability in trying out new skills and experiences in these group programs that sets the stage for growth and change. It is our job as facilitators to keep the space safe, safe for perceived successes and failures, and if that safety is there, a group can explore and take risks with new experiences and tools. Groups also add a sense of accountability that may, or may not, be as present in one on one work. Folks connect through this exploration process. I’ve seen this be encouraging when there is resistance, and it also builds trust; trust in other group members, and possibly opening the door to trust in themselves and their skills to ride whatever life brings.

Integrative Practitioner: How’s the program going thus far?

Ferretti: The feedback has been very positive. People have shared that they feel more capable, more compassionate with themselves and others, more connected, more whole. We have also had one small pilot study of 12 people and that preliminary data show that IPOP is moving the mark with anxiety symptoms. There was a statistically significant decrease in anxiety symptoms following each of the four IPOP programs, and we saw a continued decrease in anxiety across all four programs. We saw a decrease in depression symptoms as well, but not statistically significant, with the exception of MBCR. We even had two statistically significant findings on a scale that looks primarily at physical symptomology, which was not expected initially, but really isn’t that surprising since managing emotions is a full-body experience. There is a physiological aspect to an emotional experience that is often overlooked.

Integrative Practitioner: What lessons do you have for practitioners providing integrative cancer care?

Ferretti: From a medical perspective, where we tend to be looking for short, quick interventions, because of limited resources, the IPOP program is different. We’re hoping to offer skills that build on each other and develop over time. The question is, does that save resources in the future?

People who have completed the IPOP curriculum have shared with us that not only did the IPOP program help them manage cancer better, but it helped them in relationships, work, and many other areas of life. It’s easy to lose sight of how healing is a long, individual process and involves so much more than physical healing.  

I think supported exploration during that healing process can be extraordinarily helpful. In a perfect world, and what sometimes happens as the relationships between the participants and the facilitators strengthen, this support and structure comes from people that the participants have built relationships with, which is of added benefit in my mind because relationships, we know, do so much of the therapeutic work.

Editor’s note: This interview has been edited and condensed.