Preconference Workshop Descriptions

Workshop 1: Meaning-Centered Psychotherapy for Cancer Patients

Thursday, 13 February 2014, 8:00 am – 12:15 pm (15 minute break)

Description:
This workshop provides an overview of a novel counseling intervention for patients with advanced cancer, “Meaning-Centered Psychotherapy for Cancer Patients.” Participants will be introduced to the topics of meaning and spirituality as they relate to cancer care and the experience of patients with cancer. Meaning Centered Psychotherapy is based on the concepts of meaning as derived from the work of Viktor Frankl MD and adapted for use in cancer populations by our team at Memorial Sloan-Kettering Cancer Center. Two forms of Meaning-Centered Psychotherapy have been developed: Meaning-Centered Group Psychotherapy (eight weekly 1 ½ hour sessions) and Individual Meaning Centered Psychotherapy (seven weekly 1 hour sessions). Both interventions are manualized and randomized controlled trials are currently being conducted and data from these trials will be presented. Participants will have the opportunity to participate in experiential exercises utilized in Meaning Centered Psychotherapy. In addition, a detailed description of the intervention and the content of each session will be provided. New adaptations of Meaning-Centered Psychotherapy for Caregivers, Breast Cancer Survivors and Parental Bereavement will be briefly introduced.

Chairs and Speakers:
Allison Applebaum PhD, Memorial Sloan-Kettering Cancer Center
William Breitbart MD, Memorial Sloan-Kettering Cancer Center

Target Audience: Clinical psychologists, psychiatrists, social workers, chaplains, nurses, oncologists, palliative care and hospice clinicians, medical students, psychology students, physicians in training (Psychiatry trainees/fellows; palliative care trainees/fellows, oncology trainees/fellows) and researchers.

Learning Designation: Beginner to Expert

Learning Objectives:

  1. The attendees will become familiar with a structured, didactic and experiential eight session intervention for advanced cancer patients aimed at sustaining or enhancing a sense of meaning in the face of terminal illness.
  2. The attendees will become familiar with the importance of meaning, as a component of spiritual well-being, and its relationship to depression, hopelessness and desire for death in cancer patients
  3. The attendees will be introduced to adaptation of Meaning-Centered Psychotherapy for other populations and outcomes: MCP-Breavement, MCP for Breast Cancer Surviv0ors, MCP for caregivers of Cancer Patients.


Workshop 2: Helping Cancer Survivors Move Beyond Fear: Acceptance and Commitment Therapy Concepts, Skills and Research Strategies

Thursday, 13 February 2014, 8:00 am – 12:15 pm (15 minute break)

Description:
Diagnosis with cancer brings significant challenges for survivors attempting to live full and meaningful lives in the face of fear, illness and pain. Acceptance and Commitment Therapy (ACT), a “third wave” behavior therapy, with its focus on mindfulness, flexible perspective taking, values and committed action seems particularly well-suited to helping cancer patients live their best possible lives. ACT has strong empirical support for addressing anxiety and other psychological and physical symptoms in healthy and medically ill populations, with new but growing evidence for effectiveness in cancer. This highly interactive workshop will give a context for the clinical application of ACT for cancer patients and survivors, teach basic clinically applicable skills in ACT, provide an overview of research evidence for ACT and describe a model manualized intervention and research plan for addressing anxiety in cancer survivors. Skill-building and role-play in small groups will be focused on analysis and intervention in mindful awareness, perspective-taking, acceptance, and making choices based on personal values, with experiential exercises and training in practical application to psycho-oncology settings. We will describe and demonstrate ACT-consistent ways to conceptualize psychological and physical symptoms and health-related behaviors for cancer patients and survivors. For those interested in research, we will share an overview of the evidence base and our own experience with launching a research program in ACT in cancer and facilitate an interactive discussion of concepts and research strategies.

Chair:
Dianne M. Shumay PhD, UCSF Helen Diller Family Comprehensive Cancer Center

Speakers:
Stefana Borovska BS, University of California, San Francisco
Laura B. Dunn MD, University of California, San Francisco
Jennifer Gregg PhD, San José State University
Dianne M. Shumay PhD, UCSF Helen Diller Family Comprehensive Cancer Center

Target Audience: Researchers, Clinicians, Advocates, Graduate Students and Trainees Learning Designation: Beginner, Intermediate, or Expert

Learning Objectives:

  1. Conceptualize psychological symptoms in terms of an ACT framework including experiential avoidance, fusion and perspective-taking.
  2. Formulate an ACT-based intervention plan targeting mindful awareness, defusion, and clarification of personal values.
  3. Describe the research evidence for ACT in cancer and a model for researching interventions for ACT in cancer.


Workshop 3: Psychopharmacology in Cancer Care and Symptom Management

Thursday, 13 February 2014, 8:00 - 10:00 am

Description:
Clinicians have numerous tools at their disposal to help adult cancer patients dealing with symptoms of depression, anxiety, and other cancer sequelae. This workshop will focus on psychopharmacological interventions used to alleviate psychiatric and associated physical symptoms that arise in the context of cancer treatment, spanning from diagnosis to survivorship and palliative care. Target symptoms amenable to psychopharmacological intervention that will be discussed include the following: depression, anxiety, insomnia, fatigue, delirium, nausea, pain and anorexia. For each target symptom, specific medications will be identified and discussed in terms of clinical pearls, side effects, precautions and mechanisms of action. Data from key clinical trials conducted in cancer populations will be summarized and referenced for the audience as a foundation for evidence-based prescribing practices. The following classes of medications will be covered in this workshop: antidepressants, anxiolytics/hypnotics, antipsychotics, mood stabilizers and psychostimulants. Case vignettes will be used to illustrate how to formulate an appropriate and effective medication regimen in a cancer patient struggling with a complex cancer-related symptom burden. Plenty of time will be allowed for questions and discussion.

Chair:
Alan Valentine MD, UT MD Anderson Cancer Center

Speakers:
Donna Greenberg MD, Massachusetts General Hospital
Andrew Roth MD, Memorial Sloan-Kettering Cancer Center
Seema Thekdi MD, UT MD Anderson Cancer Center
Alan Valentine MD, UT MD Anderson Cancer Center

Target Audience: Clinicians, Trainees, Educators

Learning Designation: Intermediate to Expert

Learning Objectives:

  1. Identify classes and specific psychopharmacological agents used in the treatment of psychiatric and other cancer-related symptoms occurring during the course of cancer treatment, from diagnosis to survivorship and palliative care.
  2. Review key clinical trials conducted in cancer patients that guide the clinician in developing evidence-based prescribing practices.


Workshop 4: Improving Communication Regarding Reproductive Health with Adolescent and Young Adult Patients in the Oncology Care Setting

Thursday, 13 February 2014, 8:00 am – 12:15 pm (15 minute break)

Description:
Nearly 68,400 adolescents and young adults (AYAs) aged 15–39 were diagnosed with cancer in 2009. Clinical research indicates that AYA oncology patients want information and support regarding reproductive health topics (e.g., fertility preservation contraception, sexuality). Despite guidelines from professional organizations, available studies suggest few oncology professionals discuss these issues with patients, partly due to barriers such as lack of training and skills regarding communication of reproductive health topics. Led by a diverse group of faculty with clinical, research and/or advocacy expertise, the proposed workshop will help to identify needs of AYA patients, barriers, and model strategies to improve communication about reproductive health with AYA patients.

Chairs:
Gwendolyn Quinn PhD, Moffitt Cancer Center
Susan Vadaparampil PhD, Moffitt Cancer Center

Speakers:
Kristine Donovan PhD, Moffitt Cancer Center
Irma Cathy Elstner RN, Moffitt Cancer Center
Devin Murphy MSW, Miller Children's Hospital
Gwendolyn Quinn PhD, Moffitt Cancer Center
Susan Vadaparampil PhD, Moffitt Cancer Center
Rachell Moodie, Patient advocate
Joshua Rivera, Patient advocate

Target Audience: Clinical Social Workers, Psychologists, Nurses, Researchers and Advocates working with AYA populations in the pediatric or adult oncology care setting

Learning Designation: Beginner

Learning Objectives:

  1. Identify the reproductive health needs (e.g., fertility preservation contraception, sexuality) of AYAs.
  2. Observe a standardized patient and health care professionals (i.e., social worker, psychologist) discussing reproductive health issues in a clinical setting.
  3. Discuss cases of males and females patients with varying cancer types, stages, and social demographics that may impact discussion reproductive health discussion and identify strategies to improve communication based on these characteristics.


Workshop 5: Genetic Testing for Hereditary Cancer Syndromes: Family Dynamics, Communication and Medical Decision Making

Thursday, 13 February 2014, 10:15am – 12:15pm

Description:
This workshop will present a psycho-educational approach, rooted in family life cycle and family systems theories, for work with families affected by hereditary cancer syndromes. We draw heavily from the growing empirical knowledge base in hereditary cancer research to introduce participants to the ways individuals and families approach, understand and adjust to hereditary cancer risk management and care. A combination of didactic lecture, small group activities and media clips will support hands-on acquisition of practice skills. The speakers will introduce strategies for health providers to support communication with immediate and distant family members about genetic testing and risk management decisions. Speakers will focus on techniques to support authentic family communication as a vehicle to improve the accuracy of family health histories and maximize support gleaned from family networks. These techniques are designed to draw on each family’s strengths, expand their coping repertoires and enhance problem-solving skills. We will use case material from our own research and clinical practice to highlight common and unique challenges faced by families across the life cycle. Workshop participants will be introduced to resources for professional and patient edification across the spectrum of hereditary cancer syndromes, including how to find health and mental health specialists, disease and treatment information and advocacy/support groups.

Chair:
Allison Werner-Lin PhD, LCSW, University of Pennsylvania

Speakers:
Lindsey M. Hoskins PhD, LCMFT, National Cancer Institute
Allison Werner-Lin PhD, LCSW, University of Pennsylvania

Target Audience: Clinicians and Researchers

Learning Designation: Intermediate

Learning Objectives:

  1. Understand the impact of hereditary cancer risk and risk management across the life cycle, with particular attention to family formation.
  2. Gain familiarity with family systems concepts as they relate to genetic testing and cancer risk management for a hereditary cancer syndrome.
  3. Learn applications of individual and medical family therapy as they relate to cancer risk management and family communication.


Workshop 6: Acute Cancer-Related Cognitive Therapy

Thursday, 13 February 2014, 1:15 pm – 5:30 pm (15 minute break)

Description:
Acute cancer-related cognitive therapy functions in a unique environment, at a critical turning point in patients’ lives, requiring conscription of resources and urgent reorganization of priorities. This workshop teaches advanced cognitive therapy (CT) skills that have been developed at Memorial Sloan-Kettering Cancer Center to help patients through this coping crisis. There are four parts to this workshop:

  1. Why and how the acute cancer setting changes CT and how to formulate an acute cancer-related CT case. An interactive formulation of a case is included.
  2. The grain of truth behind many distorted cognitions, the tyranny of positive thinking, and fear of recurrence are examples of unique reframing challenges that will be discussed here.
  3. Prognosis, dying, desire for hastened death and suicide are unique themes of the acute cancer setting and these are considered through the lens of acute cancer-related CT.
  4. Behavioral activation and combined CT-psychopharmacology are essential skills in acute cancer settings where chronicity of stressors, pain and other biological variables worsen symptoms. How maintenance and termination of CT is different in acute cancer settings and the importance of Clinicians’ Emotional Reactions (CER) or countertransferance are also discussed.

This workshop will focus on cognitive rather than behavioral strategies. Participants are invited to bring their personal cases or cancer experiences to the workshop for discussion to consider how acute cancer-related CT might be applied.

Chair:
Tomer T. Levin MD, Memorial Sloan-Kettering Cancer Center

Speakers:
Allison J. Applebaum PhD, Memorial Sloan-Kettering Cancer Center
Tomer T. Levin MD, Memorial Sloan-Kettering Cancer Center

Target Audience: Clinicians

Learning Designation: Intermediate and Expert

Learning Objectives:

  1. Undertand the principles of acute cancer-related CT, the unique challenges of acute cancer settings and how to formulate an acute cancer-related CT case.
  2. Learn how specific acute cancer-related CT skills are applied (e.g., understanding prognosis, problem solving, the tyranny of postive thinking, self-injection, discussing death, desire for hastened death, suicide, bereavement, fear of recurrence, the “grain of truth”/realistic optimism, behavioral activation, combined CT-psychopharmacolgy and CER (countertransference)).
  3. Build the learner’s skills and confidence to use acute cancer-related CT in their clinical work in acute cancer settings.


Workshop 7: Teaching a Psychotherapy Designed for Elders: The CARE Model

Thursday, 13 February 2014, 1:15 pm – 5:30 pm (15 minute break)

Description:
In this workshop attendees will learn how to deliver a psychotherapy intervention designed specifically for elders with cancer, the CARE Model (Cancer and Aging: Refections for Elders). Based on Erikson's concepts and from interviews with "expert" elders, this five session intervention has been developed and its feasibility and tolerability tested in a telephone format. This workshop will have two parts:

  1. Background for psychotherapies in elders and background for the CARE Model with presentation of preliminary results from 65 patients by the time of the workshop.
  2. Presentation of the manual and the content of each session with role play to illustrate how to conduct the key sessions. Innovations and other formats for delivery will be discussed, as well as opportunities for collaboration.

Chair:
Jimmie Holland MD, Memorial Sloan-Kettering Cancer Center

Speakers:
Elizabeth Harvey PhD
Jimmie Holland MD, Memorial Sloan-Kettering Cancer Center
Christian J. Nelson PhD, Memorial Sloan-Kettering Cancer Center
Andy Roth MD, Memorial Sloan-Kettering Cancer Center

Target Audience: Clinicians

Learning Designation: Intermediate

Learning Objectives:

  1. The participants in this workshop will learn the common psychosocial problems faced by elders with cancer, the Eriksonian theoretical base for the model, and its clinical implementation with patients.
  2. The audience will learn how to deliver the CARE Model: delivered by telephone or group; how to use the manual as a guide; and how to conduct key sessions on loss and isolation with role play.


Workshop 8: Integrating Exercise as a Lifestyle Behavior into Survivorship Care Planning

Thursday, 13 February 2014, 1:15 pm – 3:15 pm

Description:
This workshop will address the Commission on Cancer’s 2012 Program Standard on survivorship care plans. The survivorship care plan is a comprehensive treatment summary that includes risk identification, follow-up care guidelines and recommendations for self care aimed symptom management and risk reduction. The workshop is designed to disseminate the evidence generated from research on exercise in cancer survivors, critically review the methodology and types of exercise interventions, describe alternative forms of exercise interventions, address translation to practice and provide an opportunity for participants to apply the knowledge to a patient-centered survivorship care plan.

Chair:
M. Tish Knobf PhD, RN, FAAN, AOCN, Yale University School of Nursing

Speakers:
M. Tish Knobf PhD, RN, FAAN, AOCN, Yale University School of Nursing
Byeongsang Oh PhD, Dana-Farber Cancer Institute, Harvard Medical School
Bernardine Pinto PhD, W. Alpert Medical School of Brown University

Target Audience: This workshop offers broad application to clinicians, researchers and advocates.

Learning Designation: Intermediate

Learning Objectives:

  1. Describe the effects of exercise on physical, psychological, functional and quality of life outcomes in cancer survivors.
  2. Discuss types of exercise and settings from the body of evidence with cancer survivors for translation to practice.
  3. Identify strategies to incorporate exercise as a healthy lifestyle behavior into a patient centered survivorship care plan.


Workshop 9: Helping Children Thrive when a Parent has Cancer: The Parenting at a Challenging Time (PACT) Model

Thursday, 13 February 2014, 1:15 pm – 5:30 pm (15 minute break)

Description:
Parents greatly value guidance around communicating with, and supporting children at all stages of the parent’s treatment and survivorship. This workshop will provide participants with a clinical framework from which to guide patients in doing so. Participants will gain knowledge of child development as it relates to a child’s coping with parental cancer. Particular emphasis will be placed on parent-child communication about cancer and how to manage common obstacles to open and honest communication. For instance, the workshop will address talking with children of different ages about a new diagnosis, a recurrence of illness, or the transition to palliative or hospice care; preparing children for side effects of treatment, and communicating with children with varying temperaments. We will go beyond these “basics,” and also address some common clinical challenges that arise in offering parent guidance. These may include cultural differences that affect a parent’s willingness to be honest with children about a diagnosis, unique issues that arise for single parents, and supporting children with communication or cognitive challenges. Attention will be paid to the range of clinical settings and varying levels of experience with children and families that participants bring. The workshop will combine didactic teaching, role plays, and group discussion of cases. Participants will leave with ideas and information that they can quickly integrate into clinical practice.

Chair and Speaker:
Cynthia Moore PhD, Massachusetts General Hospital

Target Audience: Psychiatrists, psychologists, social workers, oncology nurses and others who provide psycho-oncologic care to adults with cancer

Learning Designation: Intermediate

Learning Objectives:

  1. Identify benefits to patients of addressing concerns about their children in the context of parental cancer.
  2. Provide guidance to parents about four arenas in which families can focus efforts to support children.
  3. Describe how children’s developmental stages relate to how they understand and cope with parental cancer.
  4. Provide guidance to parents in addressing children’s questions about parental cancer.


Workshop 10: What’s an Evidence-Based Psychosocial Intervention Anyway?

Thursday, 13 February 2014, 3:30 pm – 5:30 pm

Description:
The goal of the workshop is to define the term “evidence-based intervention”, inform attendees of the many resources available that meet that criterion, assist them in easy access, and encourage submission of materials that they have developed for inclusion in one or more databases available through NCI networks. The Bright IDEAS approach to problem-solving skills training will be used as an example of an intervention that was reviewed and scored as part of the Research-tested Therapies and Intervention Programs (RTIPs) process. It is now available in print format through the National Registry of Evidence-based Programs and Practices (NREPP).

This workshop will be highly interactive and consist of short presentations; accessing numerous Internet sites to demonstrate effective and efficient use of available materials, references, and repositories; and an open format inviting questions and participation in hands-on demonstrations throughout the session.

Chair:
O.J. Sahler MD, Golisano Children’s Hospital, University of Rochester School of Medicine and Dentistry

Speakers:
Lizbeth Caceda-Castro MEd, MANILA Consulting Group, Inc. National Registry of Evidence-based Programs and Practices (NREPP)
O.J. Sahler MD, Golisano Children’s Hospital, University of Rochester School of Medicine and Dentistry
Cynthia A. Vinson PhD, MPA, National Cancer Institute

Target Audience: Psychosocial Oncology Interventionists

Learning Designation: All levels of clinicians or researchers are welcome

Learning Objectives:

Describe the process by which an intervention can be submitted for review and inclusion on the NREPP and RTIPs registries. Understand the review systems that assess quality of research and readiness for dissemination for NREPP, and research integrity, dissemination capability, and intervention impact for RTIPs.

Describe two mechanisms being implemented by the NIH to support the innovation and dissemination process for evidence-based therapies and intervention programs.