CBT Training For Clinicians Providing Supportive Care For Cancer Survivors

描述（由申请人提供）：对于三分之一到一半的癌症幸存者来说，情绪和认知障碍并不会随着治疗的结束而结束。认识到这一问题，医学研究所（IOM）在其2007年的报告《对整个病人的癌症护理：满足心理社会健康需求》中强调了解决心理社会问题（如痛苦）对于提供良好的癌症护理的重要性。NCI已经认识到严重缺乏训练有素的专业人员来满足这些需求。建议的培训计划旨在通过培训卫生专业人员，为癌症幸存者提供支持性护理，以实施认知行为疗法（CBT），从而减少这些生活质量问题。经验验证的CBT干预已被发现对癌症患者和幸存者产生显著的益处，包括减少心理困扰。尽管我们调查的71%的卫生保健专业人员认识到CBT的有效性，但只有5%的人报告掌握了CBT技能。超过80%的人表达了学习如何实施针对癌症幸存者的CBT技术的强烈动机。受训人员将被竞争性地挑选有执照/证书的专业人员，包括：心理学家、社会工作者和CL护士。拟议的R-25E将测试一个结构化的CBT培训课程，包括教学讨论、角色扮演和反馈。课程将分为为期3天的讲习班，每个讲习班有40名学员（总共8个讲习班共有320名学员）。将提供CBT练习册和相关期刊文章和评论章节的副本。完成工作坊后，受训者将参加六个月的随访小组电话会议，以回顾CBT技术并讨论其进展。项目评估将涉及：获得的知识和技能、幸存者福利、学员和机构接受情况以及学员满意度。

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.