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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
The set of five competencies recommended by the IOM (2003) and the set of six general competencies required by ACGME (Swing, 2002) also can contribute to the development of core psychosocial competencies, as does a model for self-assessment of knowledge and skills by health psychologists described by Belar and colleagues (2001). Similarly, Division 54 of the APA recommended 12 areas of training in pediatric psychology, which could easily be translated into competency domains (Spirito et al., 2003). The Memorial-Sloan Kettering Cancer Center has identified specific competencies for its Fellowship in Psycho-Oncology and Psychosomatic Medicine within each of the six ACGME categories and is sharing these competencies with similar programs around the country.22 For example, a core competency for fellows in the “systems-based practice competency” involves the following: “Demonstrates a knowledge of community resources available to patients for continuing psychiatric care, care for family members, support and information and advocacy services for cancer patients/survivors, and hospice/palliative care resources” (Memorial-Sloan Kettering Cancer Center, 2007:4). As discussed earlier, the subspecialty of psychosomatic medicine also was recently approved as a subspecialty in psychiatry by ACGME, and the program requirements for this subspecialty indirectly identify essential competencies (http://www.acgme.org/acWebsite/RRC_400/400_prIndex.asp). The Academy of Psychosomatic Medicine has organized a committee that is charged with developing more specific competencies for this area of practice, which will serve as yet another resource.23
Finally, the model for providing psychosocial services to cancer survivors and their families detailed in Chapter 4 should inform efforts to specify the competencies relevant to providing psychosocial services for all members of the workforce. It provides clear direction regarding the types of core competencies that should be considered essential in future efforts to develop comprehensive competency sets and related curricula. These include knowledge and skills in the following:
Communication with patients and families
Care planning and coordination
Collaboration across disciplines/specialties and work in teams
Personal communication, Andrew J. Roth, MD, Attending Psychiatrist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, March 21, 2007.
Personal communication, William S. Breitbart, MD, Chief, Psychiatry Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, March 21, 2007.