Hill Briefing Highlights Cancer Care

— Lyn Stoesen, News Staff


NASW Executive Director Elizabeth J. Clark presented information about the role of social workers in providing psychosocial care for people with cancer during a congressional briefing held on March 31.

The briefing was held to promote and discuss a report issued by the Institute of Medicine (IOM), "Cancer Care for the Whole Patient." The report, released last year, promotes an approach to care that addresses the psychosocial needs of patients with cancer [January 2008 News].

"This is an important report and includes valuable information for social workers," Clark told the News. "NASW supports its conclusions and efforts to disseminate these findings."

At the briefing, Clark spoke about "Capacity Building for Psychosocial Services for Persons with Cancer." Also speaking was Jessie Gruman, founder and president of the Center for the Advancement of Health and a member of the committee that prepared the report. Robert T. Croyle, director of the Division of Cancer Control and Population Sciences at the National Cancer Institute, facilitated the meeting.

In introductory remarks, Croyle lauded the report for its "thorough, substantive, concrete and specific recommendations" and noted an evolution at the National Institutes of Health in recognizing the strong science base of psychosocial care.

In her remarks, Gruman spoke about her own experiences as a cancer survivor and noted five important points made by the report: there is a solid behavioral and social science research base on the psychosocial impact of cancer; there is a strong evidence base supporting the recommendation to address the psychosocial needs of everyone with cancer; powerful interventions are currently available; there are vibrant and active nonprofit organizations providing psychosocial services; and while there is a clear need to treat the whole person every time, there is not yet the capacity in this country to do so.

Clark said in her remarks that she felt one of the most important parts of the report is its definition of psychosocial health services. "Taxonomy is an important piece of this issue," she said. "This definition is particularly valuable because it applies to any disease."

The report states that "psychosocial health services are psychological and social services and interventions that enable patients, their families and health care providers to optimize biomedical health care and to manage the psychological/behavioral and social aspects of illness and its consequences so as to promote better health."

Clark addressed educational responses to cancer care needs, noting the Cancer Survival Toolbox NASW helped develop with the National Coalition for Cancer Survivorship [see story in this issue]. She also noted the success of NASW's "Understanding Cancer" online continuing education course.

Clark also discussed organizational responses to psychosocial needs, such as patient-navigation projects, core competency demonstration programs and others. She reviewed legislative responses, which she said are a crucial element in securing support and funding for needed programs.

Workforce shortages are looming in a number of professions that provide cancer care, including nursing, public health, imaging technology and social work, Clark said. She clarified the size of the national social work workforce and addressed the need to recruit, retain and retrain the workforce.

She concluded that a combination of compassion, competency and funding are needed to ensure cancer care for the whole patient.

Clark is a past president of the National Coalition for Cancer Survivorship and a current advisory board member of the Intercultural Cancer Council.

IOM prepared the report following a request from the National Institutes of Health to study the delivery of psychosocial services to cancer patients and their families and identify ways to improve it. A Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting was formed to prepare the report. Social worker Diane Blum was among the committee members; Blum has worked with NASW on several projects.

The report includes chapters detailing the psychosocial needs of cancer patients, the consequences of unmet psychosocial needs, a model for delivering psychosocial health services, approaches to implementing the standard of care, public- and private-sector policy support, ways to prepare the workforce and a research agenda.

It includes seven psychosocial needs of people with cancer, including: information about illness, treatments, health and services; help coping with emotions; help managing illness; assistance changing behaviors to minimize the impact of disease; material and logistical resources; help managing disruptions in work, school and family life; and financial advice and assistance.