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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
their families in hospital settings. Additional elements of the training may involve selected readings, while a few sites offer a related course. Though asked, respondents did not identify competency sets or model curricula related to this training.
A noteworthy exemplar is Children’s Hospital of Philadelphia, with its Psychology Training Programs in Pediatric Oncology (http://www.chop.edu/hc_professionals/psych_edu.shtml). Pre- and postdoctoral training is offered, as well as supervised experiences for graduate students. These programs provide opportunities for outpatient-, school-, and community-based work in addition to hospital-based training.
Competencies and curricula Core curricular components in graduate-level clinical health psychology were first specified through a national consensus conference in 1983 (Stone, 1983). These core components centered on the social, biological, and psychological bases of health and disease; health policy, systems, and organizations; health assessment, consultation, and intervention; health research methods; ethical, legal, and professional issues; and interdisciplinary collaboration (Belar, 1990). In 1997, Belar and colleagues developed a model for self-assessment of knowledge and skills by health psychologists that drew from the content areas identified in the original consensus conference (Belar et al., 2001). The Society for Pediatric Psychology also recently published a set of recommendations for training in the subspecialty of clinical child psychology (Spirito et al., 2003), which articulate a dozen suggested “domains of training.”
Conclusions The psychology profession has seen rapid growth, expanding the potential pool of mental health professionals who can respond to the psychosocial needs of cancer patients; clear growth has occurred as well in health-related specialties, including health psychology, neuropsychology, and rehabilitation psychology. However, accreditation standards for training in psychology are very general and have limited direct applicability to psychosocial aspects of serious, complex medical illness. While accreditation standards are often referenced in the health care workforce literature as potential levers of change in efforts to influence curricula (IOM, 2003), it is difficult to envision how the current standards in this profession, given their general nature, could be modified to effect substantive change in training programs on the issues addressed in this report. Moreover, board certification does not play a major role in the field of psychology and therefore is an unlikely vehicle for effecting change.
In comparison with accreditation standards, the content domains in the national licensing exam (EPPP) are relatively specific. While the biological bases of behavior are covered, it is possible to envision adding specificity in this area addressing the psychosocial aspects of illness and recovery. Doing