CBT Training For Clinicians Providing Supportive Care For Cancer Survivors

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DESCRIPTION (provided by applicant): For between one-third and one-half of all cancer survivors, disturbances in mood and cognition do not end with the conclusion of treatment. Recognizing this problem, the Institute of Medicine (IOM) has emphasized in its 2007 report, "Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs," the importance of addressing psychosocial issues, such as distress, to providing good cancer care. The NCI has recognized that there is a severe lack of trained professionals to address these needs. The proposed training program seeks to reduce these quality of life problems by training health professionals providing supportive care to cancer survivors to implement of Cognitive-Behavioral Therapy (CBT). Empirically-validated CBT interventions have been found to yield significant benefits for cancer patients and survivors, including reduction of psychological distress. Although 71% of health care professionals we polled recognized the usefulness of CBT, only 5% reported mastery of CBT skills. And over 80% expressed high motivation in learning how to implement CBT techniques targeted for cancer survivors. Trainees will be competitively selected licensed/credentialed professionals, including: psychologists, social workers, and CL nurses. The proposed R-25E will test a structured CBT training curriculum that includes didactic discussion, role playing and feedback. The curriculum will be presented across 3-day workshops with 40 trainees at each workshop (for a total of 320 trainees across a total of 8 workshops). CBT workbooks and copies of relevant journal articles and review chapters will be provided. After completing the workshop, trainees will participate in six monthly follow-up group phone conferences to review CBT techniques and to discuss their progress. Program evaluation will address: knowledge and skills acquired, survivor benefit, trainee and institutional up-take, and trainee satisfaction. Overarching goal: to train healthcare professionals to implement CBT for cancer survivors in order to improve their quality of life. Specific aims: 1: To test the effectiveness of healthcare professional CBT training workshops using paper-and-pencil evaluations of trainee knowledge of CBT techniques, administered pre- and post-workshops; 2: To assess CBT skills gained based on trainer ratings of trainee skill during mock CBT sessions carried out during workshops; 3: To evaluate the effectiveness of training based on trainer assessment of skill demonstrated during presentation of a case presented after the sixth (and final) follow-up phone conference call; 4: To determine the effectiveness of training in terms of benefit for end-users, the survivors treated by trainees, as determined by survivors' ratings of distress on standardized measures completed before and after the CBT intervention; 5: To evaluate trainee uptake of CBT through an assessment of their continued implementation of CBT with survivors after completion of all training; 6: To determine institutional uptake of the CBT training as indicated by the institution's intention to send other staff members to future CBT training workshops; 7: To assess trainee satisfaction with the CBT professional education program. Relevance: Even after treatment is over, many cancer survivors continue to suffer from emotional distress. The proposed professional cancer education program strives to provide these survivors the best possible care by training the clinicians responsible for their supportive services to implement Cognitive-Behavioral Therapy.