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Psychosocial Care in Oncology

Emotional distress and mental health for patients and caregivers can greatly impact quality of life, treatment outcomes, and even the cost of care. While progress has been made with distress screening, finding effective and efficient practice solutions to address these needs can tax the care delivery system and contribute to staff stress and burnout.

Delivery of Psychosocial Care in Oncology Summit

To help its membership address access and delivery of psychosocial services, on March 8, 2023 ACCC hosted a multistakeholder summit in partnership with The American Psychosocial Oncology Society (APOS) and The Association of Oncology Social Work (AOSW) focused on psychosocial care delivery in oncology to:

Provide a forum for healthcare leaders, cancer care team members, and patient advocates to discuss the current state of mental health in oncology.
Build a collaborative dialogue amongst all interested stakeholders to identify action plans that address ongoing mental health issues for patients, caregivers, and cancer care team members.
Review and identify effective screening tools, training, resources, and policies to address psychological distress in patients, caregivers, and cancer care professionals.
Identify barriers to providing and accessing timely and appropriate care for patients and caregivers experiencing psychological distress.

Download Summit Pre-Reads

Executive Summary

Invitees included individuals from across the multidisciplinary psychosocial cancer care team, including key leadership representatives of advocacy organizations, licensed clinical social workers (LCSWs), licensed independent clinical social workers (LICSWs), clinical psychologists, board of oncology certified social workers (OSW-Cs), nurses, advanced practice providers (APPs), and one physician. After a day rich in discussion and interaction, the group came together to identify a series of action items that, if enacted, could create impactful change in the delivery of psychosocial care in oncology.

Download Executive Summary

Art Project Showcase: Talk About It

ACCC is proud to showcase this collaborative art project on mental health awareness and psychosocial care in oncology, sponsored by BeiGene, which debuted early this month at the 40th National Oncology Conference in Austin, Texas. Attendees had great fun coloring the mural and interacting with each other on such an important topic.

Cancer Buzz Podcast

Collaborative Care: A Model for Embedding Counseling in Oncology and Palliative Care — [MINI PODCAST] EP 128 Aug 24, 2023

Lipson Cancer Institute adapted the University of Washington’s Collaborative Care model to embed counseling services into oncology and palliative care across 6 clinic locations.
Caregiving: Examining Psychosocial Care for Those Who Experience Distress Due to Their Caregiving Role — [MINI PODCAST] EP 121 Aug 1, 2023

Caregivers experience higher levels of financial, emotional, and physical health difficulties than non-caregivers and are more likely to suffer from depressive symptoms and mental health problems. The Caregivers Clinic at Memorial Sloan Kettering Cancer Center is the first of its kind and provides comprehensive psychosocial care to family members and friends of patients who experience significant distress and burden because of their caregiving role.
Cancer Care Team Mental Health: Normalizing Helpers Seeking Help — [PODCAST] EP 114 May 25, 2023
Breaking down the social stigma that is often still associated with seeking mental health services is key to making cancer care clinicians and staff feel a "sense of safety" and that they will not be penalized for accessing mental health services.

More Psychosocial Care in Oncology Resources

From the ACCCBuzz Blog

ACCC Debuts CANCER BUZZ Podcast

August 06, 2019

ACCC’s new podcast, CANCER BUZZ, features fresh perspectives on pressing clinical, workplace, and care delivery issues that inevitably arise in oncology care. From the benchside to the bedside, CANCER BUZZ conversations will cover top-of-mind questions and real-world impact.

The inaugural episode of CANCER BUZZ—Zeroing in on Symptom Management— looks at why and how some cancer programs are creating an alternative option to the emergency room for after-hours emergent care of their patients in active treatment. Two nurses from Froedtert & the Medical College of Wisconsin Cancer Center 24-Hour Cancer Clinic—a 2018 ACCC Innovator Award winner—explain how their round-the-clock clinic is keeping cancer patients out of the ED, reducing unneeded testing and hospital admissions, and improving the patient experience.

The latest episode of CANCER BUZZ—Fostering Cancer Care Team Resiliency & Well-Being—takes an honest look at workplace stressors and the risk of burnout among members of the cancer care team. You'll hear from oncology professionals from a variety of care settings who are committed to creating a workplace culture that fosters well-being for all. This episode uncovers some strategies that have had real, positive effects on how oncology care providers feel about their work, their patients, and one another.

Each month CANCER BUZZ will deliver insights on hot topics in oncology. Be sure to listen in; you may find new solutions to the seemingly intractable challenges in your own workplace.

Tune on August 28 for the next CANCER BUZZ episode: Why Comprehensive Cancer Care Services Matter.

From Oncology Issues

A Virtual Reality Intervention for Anxiety Relief During Initial Chemotherapy Treatment
By Emery Bergey, et al.

Nurses at this NCI-designated Comprehensive Cancer Center piloted an evidence-based project that engaged an immersive virtual reality experience to reduce fear and anxiety among patients with cancer receiving chemotherapy treatment.
Collaborative Care: A Solution for Increasing Access to Psychosocial Care in Cancer Programs and Practices
By Carrie C. Wu, MD, et al.

The Collaborative Care Model uses the stepped care approach, enabling a flexible and personalized treatment approach that aligns with each patient’s specific needs.
Increasing Clinical Trial Accrual Through the Implementation of a Clinical Trials Navigator
By Alexander Spira, MD, PhD, et al.

Virginia Cancer Research Institute successfully implemented a cutting-edge clinical trials navigation program that improved the patient and provider experience and demonstrated a significant return on investment.
Delivery of Psychosocial Cancer Centers Care in Oncology Summit

Backed by strategic partnerships, ACCC held a multistakeholder meeting focused on exploring the current state of psychosocial support in oncology.
Developing a Health Literacy and Clear Communication e-Course

ACCC’s online course provides cancer care team members with the tools needed to be clear and concise in communication with patients, build awareness and skills regarding health literacy, and improve health equity.
Views: Expressing Life’s Inexplicable Events Through Art
By Susan Patricia Cooper, ATR-BC, LCAT

Through art therapy, patients with cancer can cope with the adverse events they may experience during treatment or in their daily lives.
Exploring Current Perceptions of Multi Cancer Early Detection Testing Among Healthcare Providers

ACCC conducted a comprehensive survey and a series of four focus groups to explore current attitudes, beliefs, and concerns related to multi-cancer early detection.
Pre- and Post-treatment Clinic: Providing Psychosocial Care from Diagnosis to Survivorship
Jennifer Hancock, PSYD, and Carrie Wines-Larch, BSN, RN, ONN-CG

Charleston Area Medical Center Cancer Center is the largest cancer program in Southern West Virginia. The cancer center opened a new treatment clinic to offer pre- and post-treatment visits to better help patients navigate their cancer journey.
Improving Cancer Care Teamwork
Elizabeth H. Lazzara, Joseph R. Keebler, Logan M. Gisick, Kimberly N. Williams, Stephanie Zajac, and Jillian Gunther

The absence of an optimal cancer care coordination model coupled with the vast network of providers involved in cancer care, necessitates the implementation of key strategies to strengthen care coordination.
Living Well After Cancer
By Gabrielle Riazi, Mike Alpert, Sarah Flores, Danielle Kline, Haley Allen, Aditi Vyas, Denise Johnson, and Jessica Clague DeHart

This pilot study aimed to determine the efficacy of a community-based wellness program offered to patients outside of the clinical setting.
Coping with COVID-19 in Patients with Lung Cancer
Elizabeth S. Ver Hoeve, Sarah N. Price, Tara K. Torres, Heidi A. Hamann, and Linda L. Garland

This study examined the coping strategies and psychosocial well-being of patients with lung cancer facing multiple stressors, primarily due to the COVID-19 pandemic.
Genetic Counseling Referrals Among Cancer Registry Patients Who Meet NCCN Guidelines: An Ohio Study
By Lindsey Byrne, et al.

A multicentered study based in Ohio measured genetic counseling referrals for patients with cancer.
A Multidisciplinary Consortium to Advance Counseling in Oncology

The Iowa Oncology Society launched an educational project designed to spark conversations, and raise awareness about the importance of genetic testing, counseling, and screening.
Holy Smokes! Developing a Cannabis Clinic for Patients with Cancer
By Sarah Jax, Katherine Schmiechen, and Dylan M. Zylla

The HealthPartners Frauenshuh Cancer Center has safely incorporated cannabis in the treatment of patients with cancer.
Understanding and Mitigating Disparities in Bladder Cancer Care

Disparities in evaluation, management, and mortality persist in patient populations where bladder cancer is less common.
Quality Improvement Officers Key Members of the Multidisciplinary Cancer Care Team
By Penny D. March, PSYD

The overall aim of quality improvement in healthcare is to deliver high-quality care to patients through a well-managed, high-functioning system aimed at improving the overall quality of life in the general population.
Billing for Oncology Social Work Services
By Courtney Bitz, LCSW, OSW-C, ACHP-SW

With increased recognition of the value of oncology social work services for patients, families, and providers, cancer programs and practices may benefit from a fresh consideration of billing for oncology social work services.
Technology and Cancer Care
By David R. Penberthy, MD, MBA

As technological innovation expands, it is important that cancer care finds ways to incorporate new technology that will make life easier for both the patient and healthcare provider- as well as create increasingly efficient cancer care.
Auxiliary Personnel Involved in Comprehensive Cancer Care
By Teri Bedard, BA, RT(R)(T), CPC

Comprehensive cancer care encompasses a wide range of services that are critical to high-quality care and the patient experience.
How Do You DISCO?
Lauren M. Hamel, et al.

Leveraging the Discussions of Cost App to reduce financial toxicity and improve treatment cost communication.
Integrating Spiritual Care in the Outpatient Oncology Setting
Alison Snow, PhD, et al.

Spiritual care providers support the religious and spiritual needs of patients and their caregivers.
An Oncology Nurse Residency Program Improves Knowledge of Delirium in Older Patients with Cancer
Cassandra Vonnes, DNP, GNP-BC, AOCNP, CPHQ, FAHA, et al.

This program helps newly licensed nurses practice safely and accurately to become competent clinicians in oncology, enhancing their critical thinking and clinical decision-making skills when treating older adults with cancer and delirium.
Rapid Practice Change During COVID-19 Leads to Enduring Innovations and Expansion of Integrative Oncology Services
Danielle Gentile, PhD, et al.

This cancer program continues to meet patients’ psychosocial needs through enduring telehealth expansion, livestream groups and classes, and on-demand digital repositories.
A Focus on APPs
Sibel Blau, MD

While the number of oncology patients and survivors is increasing, the growth of medical oncologists has lagged behind, and advanced practice providers (APPs) play a critical role in filling this care gap.
Tailoring Distress Screening in Oncology Populations
Laura Melton, PhD, ABPP, et al.

Because interdisciplinary teams become specialists in treating certain disease sites, it is important to develop distress screening guidelines that best serve specific patient populations and their treatment.
Demonstrating Measurable Value: Distress Screening
Amanda Patton, MA

Oncology Issues talked with Karen Clark, MS, manager of Supportive Care Programs, City of Hope, about the process, how the digital distress screening tool is currently integrated into the electronic health record (EHR), and next steps.
Real-Life Stories of Ordinary People with Extraordinary Bravery: A Conversation with the Author of Between Life and Death
Barbara A. Gabriel, MA
Implementing a Transportation Hub: A Holistic Approach to a Systemic Problem
Rachel Marquez, BS, MPH

Patients with cancer who face transportation barriers often find themselves at a crossroads: They must either continue to piece together various forms of assistance to try to complete a treatment regimen and protocol or throw in the towel altogether. Instead of reacting to patients’ needs after they fall out of compliance with their specified treatment, we pledged to proactively offer and find transportation assistance that meets all patient needs.
A Nurse Navigator Led Community-Based Cardio-Oncology Clinic
Rachel Zirkelback, BA, et al.

Dr. Vijay Rao and Dr. Eric Stephen Rubenstein returned from a Global Cardio-Oncology Society meeting g with the realization that they could do much more to protect patients with cancer from potential cardiac toxicity of chemotherapy. The two shared one goal: to prevent the cancer survivor of today from becoming the heart failure patient of tomorrow.
Trending Now in Cancer Care
Alexandria Howson, PhD

Rather than fielding its annual Trending Now in Cancer Care survey while cancer programs were experiencing unprecedented challenges due to the extended public health emergency, ACCC chose to facilitate conversations with its members to capture the lived experiences of the most pertinent issues impacting oncology practice and care delivery.
Compliance: Behavior Health Assessment and Intervention for Oncology Patients
A 3D Lung Nodule Tool Improves Patient Distress Following LDCT
Theresa Roelke, MSN, RN, AGNP-C

To improve the care of these patients, MaineHealth, Maine Cancer Care Network designed a study to explore the use of a 3D lung nodule tool to help providers educate patients during shared decision-making consults.
Expanding Patient Access to Cancer Care Services
Kelley D. Simpson, MBA; Stacy Melvin, MHA; and Sue Fletcher, RN

Key results from a national survey show a range of new initiatives.
Telehealth at Its Best: Transitioning a Comprehensive Psychosocial Program to a Virtual Format
Jennifer Bires, MSW, LCSW, OSW-C, and Drucilla Brethwaite, MSW, LCSW

Due to the COVID-19 pandemic and its associated risks for patients with cancer, all Life with Cancer programming was cancelled on Mar. 12, 2020. Staff, struggling with their own anxiety over personal safety, quickly went into action on how best to continue to meet the psychological and educational needs of patients and families.
Improving Cancer Care by Addressing Food Insecurity
Tracey F. Weisberg, MD

Our results indicated that food insecure patients tended to complete fewer months of treatment than their food secure counterparts. Food insecure patients who refused assistance had the lowest number of months of completed treatment; most food insecure patients who received assistance completed more of their treatment.
Cancer Life reiMagined: The CaLM Model of Whole-Person Cancer Care
Rebekkah M. Schear, et al.

Co-designing a model with patients, survivors, and the community.
Young Adult Parents Tap into Long Distance Support
Laura Melton, PhD, ABPP

We proposed creating an online video support group to enable patients with cancer who would otherwise have difficulty attending such groups to participate virtually.
Implementing Oncology Distress Screening in a Large Academic Health System
Marianne Pearson, LCSW, AND Laura M. Melton, PhD

A step-by-step guide on how to develop and implement a health system-wide distress screening tool.
Geriatric Assessment, Multidisciplinary Model is Focus of FITNESS Study in Older Adults
Amy Hindman

The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute’s Cancer and Aging Resilience (CARE) Clinic goes beyond reviewing cancer-specific treatment. This new care model pairs patients with a multidisciplinary team to assess patients for balance, cognition, nutrition, symptom management, and many more—all in one visit.
Supportive Care Just When Patients Need It
By Tina Curtis, DNP, MBA, RN, NEA-BC, and Elizabeth Malosh, MSN, RN, NE-BC

For patients with cancer experiencing symptoms outside of business hours or when same-day appointments are unavailable, the usual options are to wait until the next day or visit the emergency department (ED). However, ED visits come with clinical and financial risks for oncology patients. Read how The Clinical Cancer Center at Froedtert Hospital developed a 24-hour urgent care oncology clinic to reduce ED use, eliminate redundant services, and alleviate financial burden.
A Physician Champion Takes a Practice-Based Immunotherapy Program to the Next Level
Tracy Virgilio, RN, MSN, OCN

Early symptom management is key to improving quality of life for patients with cancer, and proactive monitoring delivers unparalleled survival advantage while decreasing emergency visits and admissions. However, immunotherapies require special attention and procedures. Sidney Kimmel Cancer Center earned a 2018 ACCC Innovator Award for their immunotherapy triage algorithms, which provide non-oncology physicians and nurses with the tools to manage IO patients and prevent unnecessary admissions.
Technology Unlocks Untapped Potential in a Financial Navigation Program
By Clara Lambert, BBA, OPN-CG; Scott Legleitner, BA, LPhT, SST; and Kathleen LaRaia

While financial navigation programs ease the burden of financial toxicity on patients with cancer and help healthcare organizations with revenue loss, the manual nature of the process is challenging for navigators and financial advocates. Cowell Family Cancer Center piloted a financial navigation software program to analyze the effects of automation on productivity, workflow, and organizational alignment.
Community-Based Psychological First Aid for Oncology Professionals
Sam Gaster, MA; Christina Early, MSW; Amanda Reed, PhD; and Brandon Gray, MA

Training in community-based psychological first aid is a promising intervention that promotes adaptive functioning by instilling individuals with the knowledge and skills necessary to support oneself and others when stressful events occur.
Views: The Trauma of Cancer
By Kelly Grosklags, LICSW, BCD

I have worked with oncology patients in some capacity for 25 years, but hearing “posttraumatic stress disorder” (PTSD) and “cancer” in the same sentence is a relatively new concept for most.
Patient Care Connect
By Warren Smedley, MSHA, MSHQS, and Gabrielle B. Rocque, MD

Though the concept of patient navigation is not new, the use of lay navigation teams across the continuum of a cancer journey is a novel approach to care coordination. Integrating lay navigators into the healthcare team empowers the clinical team to work at a higher level within the scope of their training.
Beyond the Classroom: Students Improve Access to Supportive Care Services
By Bridget LeGrazie, APN; Brie Bernhardt, MSW, LSW; and Lisa Rosenberry, MS, MSW, LCSW, OSW-C

In 2016 Virtua Cancer Program saw approximately 2,400 analytic cases across three ncampuses. Our two full-time (FTE) social workers were challenged to meet this high patient demand, and it soon became clear that improvements were needed
Geriatric Oncology Ambulatory Care Clinics
By Janine Overcash; Sandra Abels; H. Paige Erdeljac; Susan Fugett; Brittany Knauss; Elizabeth Kress; Cari Utendorf; and Anne M. Noonan

The role of the geriatric oncology ambulatory care clinic is important to the care of the older person in that it assembles a multidisciplinary team of oncology professionals specialized in aging and who work together to conduct comprehensive geriatric assessment and develop a cancer management plan.
Life with Cancer at Inova Schar Cancer Institute
By Sage Bolte, PhD, MSW, OSW-C

Learn how Inova Schar Cancer Institute’s Life with Cancer program, with more than 40 multidisciplinary staff members, comes together to offer psychosocial support and survivorship care.
Oncology Distress Screening: Distress prevalance, new standards, implementation
Kendall J, et al.

Oncology Distress Screening: Distress prevalance, new standards, implementation
Growing a Psychosocial Oncology Program within a Cancer Center
Hamann HA and Kendall J.

Growing a Psychosocial Oncology Program within a Cancer Center
Catalyzing Patient-Centered Care—Start Where You Are and Share What You Know
Pratt-Chapman, et al.

Catalyzing Patient-Centered Care
Distress Screening for Oncology Patients
Buxton D, et al.

Distress Screening for Oncology Patients
Bridging the Psychosocial and Financial: A Model for Decreasing Patient Distress, While Ensuring Your Program’s Financial Viability.

Bridging the Psychosocial and Financial
From Distress Screenings to Solutions
Lori McMullen, RN, MSN, OCN

At the Edward and Marie Matthews Center for Cancer Care, Plainsboro, N.J., the process for developing and implementing psychosocial distress screening began in January 2013.
A Cognitive Approach to Cancer Treatment
Marlena Ryba, PhD

Too often, the emotional burdens accompanying cancer lead to early withdrawal from chemotherapy, for example, and poor outcomes. However, a series of clinical studies suggest psychotherapy can counter those effects, with powerful implications for patients.
Building a Navigation and Psychosocial Support Program from the Ground Up
Lori McNulty, RN, and Faye Flemming, RN, BSN, OCN

At ACCC member Southside Regional Medical Center, an oncology nurse navigator heads up navigation and psychosocial services, including partnering with a local community agency to help meet high referral and patient demand.