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Learned Helplessness in Chronic Illness — SCE Palliative Medicine MCQ

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ModeratePsychological & PsychiatricLearned Helplessness in Chronic IllnessSCE Palliative Medicine

A 72-year-old man with advanced prostate cancer and chronic pain has developed features of "learned helplessness"—he has stopped engaging with rehabilitation, refuses to try new activities, and says “nothing will help.” What psychological intervention is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Graded activity scheduling with achievement‑based goals (behavioural activation) combined with cognitive restructuring of helplessness beliefs

Option B is correct. NICE CG91 recommends guided self‑help using CBT principles including behavioural activation and problem‑solving for people with chronic physical health problems and depressive symptoms, restoring engagement and challenging helplessness cognitions. In chronic pain, NICE (NG193) endorses CBT as an appropriate psychological therapy that improves quality of life. Option D (stimulants) lacks evidence for reversing helplessness; Option C is unethical and likely harmful; Option A is unhelpful and risks alienation; Option E misattributes psychological helplessness to inadequate analgesia and may worsen functional decline without addressing cognitive‑motivational deficits.

Reference: NICE CG91 (Depression in adults with chronic physical health problems) – low‑intensity psychosocial interventions including behavioural activation and CBT (2009, reviewed 2024); NICE NG193 (Chronic primary pain) – psychological therapy including CBT (2021).