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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
fields, accreditation standards are less prescriptive regarding the teaching of evidence-based practices.
This focus on competency identification is occurring broadly in other disciplines as well. Various mental health professions are developing competency models in such disciplines as marriage and family therapy, psychology, advanced practice psychiatric nursing, and psychiatric rehabilitation. Cross-disciplinary competencies are being developed for practice with specific populations, such as children and adults with severe mental illness. Other initiatives have focused on competencies for special treatment approaches, such as recovery-oriented care, peer support, and culturally competent care (Hoge et al., 2005a). The inadequate delivery of psychosocial health care in oncology suggests that there also may be benefits to specifying the competencies necessary for providing psychosocial services to medically ill patients in general, and to cancer patients in particular.
There are existing resources and some positive developments that could be used to advance the use of core competencies for the psychosocial care of cancer patients and their families. C-Change (http://www.c-changetogether.org), a coalition of federal and state government agencies, cancer centers, professional organizations, private businesses, nonprofit groups, and business leaders and individuals in the private sector whose missions relate to cancer research, control, and/or patient advocacy, has undertaken a major initiative to strengthen the core competencies of the cancer care workforce. The goal of this initiative is to develop and disseminate basic cancer care competencies to the general health care workforce—that not specializing in oncology. This focus on the nonspecialist workforce is deliberate, based on data showing an expanding need for oncology care that is not accompanied by as expansive a growth in the specialty oncology workforce. C-Change recognizes that the general health care workforce, as well as the specialty oncology workforce, needs to be competent in delivering cancer care (Smith and Lichtveld, 2007).
C-Change has already defined a set of core workforce competencies, many of which address the psychosocial services and interventions recommended in the committee’s model and standard for care (see Box 7-6). C-Change plans to work with pilot sites to implement the competencies in 2007. Based on the results of this pilot test and evaluation, in 2008 C-Change plans to pursue national dissemination of the core competencies through academic, health care, and professional organizations, as well as through comprehensive cancer control coalitions. The core competencies and to-be-developed curriculum resources will be able to be integrated into (1) basic health professions education curricula used at academic institutions, (2) continuing education programs and licensing requirements of health professional societies, and (3) worksite training programs offered by employers of health professionals (Smith and Lichtveld, 2007).