Date of Graduation


Document Type


Degree Name

Doctor of Philosophy in Counselor Education (PhD)

Degree Level



Rehabilitation, Human Resources and Communication Disorders


David Christian

Committee Member

Erin Popejoy

Second Committee Member

Kristin Higgins

Third Committee Member

Wen-Juo Lo


Anxiety, Cancer, Hand holding, Lymphoma, Relationship Attachment


The purpose of this dissertation was to explore how the anxiety levels of non-Hodgkin’s lymphoma patients receiving chemotherapy are affected while holding hands with a secure attachment. This study utilized three experimental single-case designs: participant one measured under a B-design, participant two measured under a B-A design, and participant three measured under an A-B design. Each participant’s anxiety was assessed during six chemotherapy treatments and one meeting with their primary oncologist to discuss the prognosis of their cancerous disease. Results visually indicate a greater effect on anxiety reduction during treatment when the intervention is utilized compared to only having a secure attachment present. Visual analysis revealed a reducing trend in anxiety for participant one when holding hands. Participants two and three’s anxiety continued to decline while holding hands throughout treatments but increased when hand holding was removed. Follow-up interviews of all three participants support the positive effects hand holding had on anxiety reduction during treatment. The results of this study may inform mental health professionals and oncology care teams consulting cancer patients about effective coping interventions against anxiety experienced during treatment. Future research should replicate this study focusing on single-case reversal designs.