With a different voice: integrating the psychosocial perspective into routine oncology care

We have established a psychosocial support system that is highly integrated with physician activities and that is tailored to the special needs of our patient population. The core of this system is the close interaction between the physician and the patient counselor, who is a clinical social worker and psychotherapist. Viewed as a permanent member of the breast cancer team, the patient counselor provides psychosocial care in the oncology clinic using normal clinic events as vehicles for interaction. Thus, time spent waiting in the clinic and follow-up phone calls can be converted to sessions for psychological counselling. This approach has been effective in our patient population, where social biases and financial constraints limit the use of out-of-clinic psychiatric services.