Psychosocial care of the patient with cancer. A model for organizing services

Although the need and demand for psychosocial oncology services among patients with cancer is likely to grow, access to psychosocial services varies widely within treatment settings. Surveys and observations by clinicians indicate that these services are inadequate at most sites. There are many obstacles to service organization in this patient population. This article describes a model for delivering integrated psychosocial care that has applicability in cancer centers and other settings.

Psychosocial oncology services in the Comprehensive Cancer Center of Wake Forest University have been systematically organized into two program components: the Cancer Patient Support Program (CPSP) and the Psychosocial Oncology Program. These programs are unique in offering psychosocial support and counseling services that are integrated into the medical care of patients. The CPSP provides services through clinical staff members, core volunteers, and doctoral- and master's-level counseling students. The type of social support provided includes emotional support, help with tasks, informational support, and companionship support. The Psychosocial Oncology Program provides psychological assessment and counseling for patients and family members suffering from more intense psychological disturbance. A doctoral-level licensed practicing psychologist and a part-time master's-prepared counselor, both with responsibilities in the CPSP as well, make up the staff.

The key element in any psychosocial oncology program is the healing relationships formed when one person cares for another. In the psychosocial oncology service structure described, patients with cancer and their families have the opportunity to be served on two different levels, depending on the intensity of the psychological disturbance. The time has come for psychosocial services to be offered in all treatment settings. The psychosocial oncology programs described here can be replicated in most cancer centers.