Framework for planning the delivery of psychosocial oncology services: An American psychosocial oncology society task force report

Abstract

Objective: While screening for psychosocial distress is now the standard of care in oncology, little guidance is available on how best to deliver services in response to identified needs. The American Psychosocial Oncology Society (APOS) convened a task force with the goal of creating a framework that could aid in planning services and justifying requests for resources. Methods: Ten experts from multiple disciplines within psychosocial oncology served on the task force, first meeting together as a larger group over 2 days to set an agenda and then subsequently working in smaller teams to execute the goals. The task force used consensus methods for developing recommendations. Results: Three principles were identified for the framework. First, psychosocial oncology is a key component of population health, and population-based approaches to care delivery are required. Second, several key parameters shape psychosocial oncology services: resources, aims, and scope. To guide resource allocation, example priorities were identified for the aims and scope of services. Finally, cancer care centers should strive to ensure the delivery of high-quality psychosocial oncology care across all components of care. A range of practices was ranked by their potential contributions to achieving that goal. Conclusions: This framework may aid in planning, evaluating, and refining the delivery of responsive psychosocial oncology services.

Addressing distress management challenges: Recommendations from the consensus panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work

“…246 Pirl and colleagues provide a similar endorsement of collaborative care, taking into account the variability of institutional mental health resources. 61 Collaborative care models are evidencebased, team-based approaches that increase access to mental health care and improve depression symptoms for patients in oncology settings while also being relatively more costeffective. 232,247,248 These models can also be extended to serious mental illness and cancer.…”

“…Given the increased risk of suicide among patients with cancer, 59 it is particularly important to screen for suicidal ideation and establish pathways to triage, refer, and link to mental health services. Evidence‐based care delivery models, such as collaborative care (discussed below in more detail), have been adapted to proactively address the mental health needs of patients with cancer and extend the reach of psycho‐oncology services 60,61 …”

“…Butow and colleagues provide a useful review of a stepped care model, including a description of evidence‐based interventions for each level of care 246 . Pirl and colleagues provide a similar endorsement of collaborative care, taking into account the variability of institutional mental health resources 61 . Collaborative care models are evidence‐based, team‐based approaches that increase access to mental health care and improve depression symptoms for patients in oncology settings while also being relatively more cost‐effective 232,247,248 .…”

“…Evidence-based care delivery models, such as collaborative care (discussed below in more detail), have been adapted to proactively address the mental health needs of patients with cancer and extend the reach of psycho-oncology services. 60,61 Symptom management (pain control) and treatment adherence for patients with substance use disorders can be enhanced by: screening for a history of substance use (particularly alcohol and opiate use disorders), the use of universal precautions for opioid management, regular monitoring of aberrant drug-related behaviors (eg, urine drug testing, prescription monitoring programs, red flag behaviors), 62 training of oncology clinicians, co-management of substance misuse, and the use of evidence-based treatments, including medication-assisted treatments. 55,63 As noted above, the most affordable and feasible approach for addressing these problems in the population of patients with cancer is to train oncology and psycho-oncology clinicians to co-manage pain and addiction in their patients, with referral to specialty clinics for addiction management when needed.…”

Development of a psychosocial oncology core curriculum for multidisciplinary education and training: Initial content validation using the modified Delphi Method

“…9 While great strides have been made in distress management, [10][11][12][13] with reductions in patient distress, emergency visits and hospitalizations, 14 access to evidence-based interventions is limited, in large part due to the limited availability of specialty-trained providers. [15][16][17][18] The goals of the APOS core curriculum project are to (1) validate core content and competencies, (2) create a standardized core curriculum, and (3) translate this to a virtual program to build workforce capacity in PSO, particularly in underserved communities. The overarching goal is to improve access to quality psychosocial care for patients and caregivers.…”