The overall objective of this project, entitled Meaning-Centered Psychotherapy Training for Cancer Care Providers, is to develop a multi-modal training program in Meaning-Centered Psychotherapy (MCP) for multidisciplinary cancer care clinicians who provide psycho-oncology and psychosocial palliative care services for advanced cancer patients. This program will train approximately 240 selected clinicians from diverse cancer and palliative care clinical settings in the delivery of MCP. Over 5 years, 20 to 30 MCP Training (MCPT) participants will be trained in 8 to 12 MCPT sessions, using Memorial Sloan Kettering Cancer Center (MSK) Department of Psychiatry & Behavioral Sciences Psychotherapy Laboratory Faculty (the developers of MCP) and the facilities of MSK's Communication Skills (Comskil) Training Program Facilities. The acquisition of clinical MCP skills by MCPT participants, as well as the impact of the program on patient outcomes, will be evaluated using RE-AIM methodology led by an expert in this approach. Training will use a multi-component program of didactics, group experiential learning, and a curriculum based on published MCP training manuals. Trained actors will be used as simulated patients, and video recordings will allow feedback during training. A web-based application of clinical guidance, case examples, postings of relevant readings, webinars that describe strategies for managing challenging MCP cases, and social media platforms will be provided throughout and after the MCP training. Interactive responses to postings, facilitation of discussion boards, and a listserv will also be made available by the research faculty. The long-term goal of this proposal is to expand the availability of MCP in significantly more cancer and palliative care treatment settings by training a large cadre of clinicians.
Specific aims are: 1) develop and establish a MCP Training Program for selected cancer care clinicians from multiple disciplines who provide psycho-oncology and psychosocial palliative care services for advanced cancer patients; 2) evaluate MCPT participants' MCP skill acquisition through trainers' ratings; participants' satisfaction with the program; and participants' adoption, implementation, and maintenance of skills; and 3) assess the effectiveness of MCPT on patient outcomes in each MCPT participant's own clinical practice setting with advanced cancer patients. This MCPT program will increase clinicians' ability to treat advanced cancer patients and enhance patients' quality of life. Institutional support at MSK exists, after the demonstration of this R25's success, to create a psychotherapy training institute that would continue the institution's commitment to disseminate effective interventions developed at MSK.
Psychological and spiritual domains of end-of-life care have been identified as unmet priorities by both medical professionals and cancer patients alike as documented in the Institute of Medicine (IOM) report entitled, 'Approaching Death: Improving Care at the End of Life.' Meaning-Centered Psychotherapy (MCP), developed by Breitbart and colleagues at Memorial Sloan Kettering Cancer Center (MSK), is the only empirically- supported treatment that has clearly demonstrated efficacy in improving quality of life and spiritual well-being and in alleviating existential distress, loss of meaning, despair, and physical symptom burden distress in patients with advanced cancer. The overwhelming demand for training in MCP by psychologists, social workers, counselors, nurses, chaplains, palliative care practitioners, and psychiatrists and physicians working in oncology and palliative care both nationally and internationally can now be addressed in this innovative R25- supported training program in MCP, led by its developers at MSK.