Training clinical providers in evidence-based hypnosis for cancer pain management

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Rationale: In 2019, over 1.7 million Americans will be diagnosed with cancer. Among the innumerable rigors associated with the diagnosis, perhaps the greatest source of suffering is pain. Pain can be associated with the cancer itself, as well as with cancer treatments including. It is estimated that 39% of patients experience pain following curative treatment, 55% during anticancer treatment, 40%of survivors experience pain,and 66% of patients in advanced, metastatic, or terminal disease phases report pain. Unfortunately, approximately third are one- of patients with cancer-related pain are undertreated for that pain, and that the odds of undertreatment twice as high for minorities Major cancer organizations have published pain management guidelines which. recognize (e.g., hypnosis. The inclusion of hypnosis in these guidelines is based on a evidence supporting the clinical efficacy of hypnosis for acute and chronic pain management. Meta-analysis has the importance of integrating mind-body approaches ASCO, NCCN), among long history of empirical which is indicated that on average 77%-95% of patients benefit from hypnotic pain management relative to control participants. However, hypnosis training is not a standard component of either standard cancer provider education or pain management training. As a result, this clinically efficacious intervention is rarely used by providers to help patients in need. Objective: The goal of the proposed R25E is to train cancer care providers in hypnosis to manage cancer pain. The Specific Aims are to: 1) Refine and implement a Hypnosis for Cancer Pain (HCaP) training program; 2) Evaluate the effectiveness of the HCaP training on providers' knowledge, skills, attitudes, and self-efficacy for using hypnosis to manage cancer pain; and, 3) Evaluate the impact of the HCaP training program on trainees' real-world practice, using a mixed-methods approach. The HCaP training content is guided by sociocognitive theory. Training will focus on the following domains: 1) Understanding Cancer Pain; 2) Understanding Hypnosis; 3) Using Hypnosis for Cancer Pain Management; 4) Using Hypnosis for Managing Symptoms, Thoughts, and Behaviors Associated with Pain; and, 5) Hypnosis Metacompetencies (e.g., therapeutic alliance, empathy, cultural sensitivity). The evaluation plan for HCaP is guided by Miller's pyramid of clinical competencies, and will focus on three levels of evaluation: Knowledge and Practical Understanding, Skills, and Clinical Practice. Methods: Cancer care providers (N=400; including medical, allied, and psychosocial providers) from across the country will be recruited via professional organizations, listservs, and conferences. Trainees will participate in a blended training program including multimedia E-Learning and a 2-day live workshop, with evaluations linked to each modality. Trainees will also be evaluated at 3 months following the workshop. Long-term goals: The proposed R25E is a critical first step toward improving quality of care and quality of life for cancer patients in pain. Connection to NCI mission: This project is consistent with the Healthy People 2020 goal of improving quality of life of cancer patients and survivors.