Considering Anne’s lack of antecedents to self-advocacy, her difficulty in self-advocating is
not surprising. Instead of creating a ‘new normal’, taking ownership of her cancer and
feeling empowered, her thoughts and cognitions seem stuck in feeling victimized by the
cancer and her healthcare team and unable to move out of a state of passivity and regret. She
is unable to effectively navigate the healthcare system, make informed choices that benefit
her, or build teamwork with her care team. Anne does not mention any availability or use of
outside support groups or organizations. She does not indicate having a source of support or
encouragement. Without the key attributes of self-advocacy she continues to struggle with
poorly managed symptoms and feels hopeless and frustrated. She states: