As noted in the 2008 Institute of Medicine report, Cancer care for the whole patient: Meeting psychosocial health needs, the psychological distress of the vast majority of cancer patients is not addressed, posing a serious public health problem for the U.S. health care system. The NCI has acknowledged this by designating supportive care and quality of life issues of cancer survivors as health priority areas. However, progress has been limited for at least two reasons: 1) There is a gulf between the availability of empirically supported treatments (ESTs) that can produce psychosocial and health benefits for patients and their dissemination;and, 2) There are few mechanisms for supportive care professionals to receive any training in the latest developments in evidence based cancer control approaches. To address both gaps, 8 three-day training institutes are proposed for competitively selected (N=320) psychologist, social worker, and mental health clinical nurse specialists. The curriculum will be the empirically supported Biobehavioral Intervention (BBI). This treatment has yielded robust and enduring gains, including reductions in patients'emotional distress, improvements in social support, treatment adherence (chemotherapy), health behaviors (diet, smoking), and symptom and functional status, and reduced risk for cancer recurrence. Training components will include stress reduction, communication with health care providers, social support, problem solving, health behaviors, sexuality, and maintenance of change. Guided by the RE-AIM model (Reach, Effectiveness, Adoption, Implementation, Maintenance) of Abrams  and Glasgow et al.  program evaluation and dissemination will have a multi-level plan, with primary level benchmarks being success in educating trainees in BBI understanding and delivery;the secondary level being the trainee's clinical use of BBI;the tertiary level being an open label (phase II) trial of the BBI as disseminated to and implemented by trainees;and, the fourth level benchmarks being adoption of the BBI at the trainees'institution and uptake of the published BBI therapist and patient manuals. The overarching goal is to train supportive care professionals in the use of the BBI in order to improve care of cancer patients and survivors by the delivery of empirically supported psychosocial treatment.
There are insufficient numbers of psychologists, social workers, and mental health nurses that have adequate training to provide the best supportive care treatments to cancer patients. This occurs because there are few, if any, workshops being offered to train professionals. This R25E application seeks to train mental health providers from around the nation in a proven psychological treatment to meet that need.