36th Annual CAPO Conference: Advocating for All: Psychosocial Oncology at the Intersections of Equity, Diversity, and Inclusion, 8–10 June 2021

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the Abstracts from the 2021 Annual Conference, titled “Advocating for All: Psychosocial Oncology at the Intersections of Equity, Diversity, and Inclusion”. The Conference was held virtually from 8 June 2021 to 10 June 2021. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over one hundred (100) abstracts were selected for presentation as symposia, 20-minute oral presentations, 10-minute oral presentations, 90-minute workshops and poster presentations. We congratulate all the presenters on their research work and contribution.

One Thousand Lives

This chapter provides an overview of the foundational contributions of early leaders in psychosocial oncology and palliative care that informed the development of the Managing Cancer and Living Meaningfully (CALM) intervention. This includes the collective works of such pioneers as Kübler-Ross, Glaser and Strauss, and Pattison, which were instrumental in the development of psychosocial interventions such as CALM. The research conducted by our team with advanced cancer patients and their families over two decades is also described, highlighting the longitudinal Will to Live Study. In that study over 700 patients with advanced cancer were assessed at baseline and over 400 were followed longitudinally until the end of life, deepening our understanding of their experience over the trajectory of this disease. The findings of this research confirmed the need for an intervention such as CALM and helped to shape its nature and form.

Delivering Integrated Psychosocial Oncology Care

This chapter describes how the collaborative care model can be used to integrate psychosocial care into cancer care. It also describes the evolution of, and evidence for, the collaborative care approach in cancer services. Collaborative care consists of systematic identification of need, integrated delivery of psychosocial care by care managers with specialist supervision, and the stepping up of care based on the systematic measurement of outcomes. Trials of this approach for the management of depression and pain in patients with cancer have found it to be feasible to deliver, effective in improving outcomes, and cost-effective. The chapter describes how to overcome patient, provider, and institutional challenges in providing psychosocial care in diverse oncology settings. It concludes by proposing practical steps for implementing and sustaining an integrated psychosocial oncology service based on the principles of collaborative care.

Psychiatric Disorders in Pediatric Psycho-Oncology

For patients and families affected by pediatric cancer, distress is often part of a larger picture of adjustment and resiliency. Pediatric psychosocial oncology clinicians should be proficient in recognizing clinically significant psychiatric symptoms, syndromes and disorders, in order to differentiate these from normal distress and adjustment. Access to child and adolescent psychiatric expertise is an essential component of care for children with cancer and their families. It is feasible and important to differentiate psychiatric syndromes from normal trajectories of adjustment to a life-threatening diagnosis. The chapter reviews psychiatric presentations in children, and youth with cancer and treatment considerations, with a focus on the role of the pediatric consultation-liaison/psycho-oncology psychiatrist on a multidisciplinary team.

The Engaged Patient

Patient engagement is ever more essential to developing innovative strategies that shape how comprehensive, integrated medical care is delivered to cancer patients and their families. With over 300 licensed professionals across the network, Cancer Support Community (CSC) is the largest nonprofit employer of psychosocial oncology mental health professionals in the United States. Through decades of working with cancer patients, families, and caregivers, CSC has developed a portfolio of evidence-informed programs that engage patients around their most pressing concerns—unwanted aloneness, loss of control, and lack of hope. CSC’s facilities, which provide support groups, education, exercise and nutrition classes, children’s programs, and social activities, are available at no cost for families. These services are replicated on CSC’s helpline and digital platforms. This chapter highlights a comprehensive integrated model of developing and delivering evidence-informed psychosocial programs and services in the community. The chapter also reviews CSC patient-centered research projects including (1) the Cancer Experience Registry®, an online observational study of cancer patients, survivors, and informal caregivers to identify and quantify their psychosocial experiences; (2) CancerSupportSource®, a reliable, valid, multidimensional distress screening program for patients and caregivers; and (3) Open To Options®, a shared decision-making program that helps patients prepare a highly personalized list of questions, concerns, and goals to share with their doctor. The extent to which the psychosocial oncology community can integrate care across healthcare systems, by leveraging new technologies, behavioral and implementation science principles, and community-based services, will determine its success in meeting the needs of cancer patients.