Social Problem Solving and Posttraumatic Growth New Possibilities in Postoperative Breast Cancer Survivors.

The purpose of this study was to examine whether social problem solving (SPS) would relate to posttraumatic growth (PTG), particularly new life possibilities in breast cancer survivors. Participants included 85 women who had undergone surgical intervention for breast cancer at least 6 months prior to study participation. Participant ages ranged from 29 to 88 years. The majority of the sample was White (86%), married (58%), and had received at least some postsecondary education (73%), and all participants spoke English. This IRB-approved cross-sectional study was part of a larger study examining psychosocial protective and risk factors in breast cancer survivors at a university-affiliated private hospital. We hypothesized that better SPS ability would relate to PTG new possibilities above and beyond age, annual income, and time since surgery. Results from this study indicate that a positive problem orientation and lack of impulsive/careless problem-solving style appear to play a role in posttraumatic growth among breast cancer survivors, particularly in developing beliefs about one's ability to positively change one's life. Given the established benefits of active/approach coping in cancer populations, it makes sense that similar interventions such as problem-solving therapy, a cognitive-behavioral therapy that includes challenging and reframing negative beliefs about self and situation, may promote new possibility beliefs in this population.

Impact of the mental health and dynamic referral for oncology (MHADRO) program on oncology patient outcomes, health care utilization, and health provider behaviors: A multi-site randomized control trial.

OBJECTIVE: The MHADRO assesses psychosocial and medical needs, provides tailored feedback reports, and connects patients to mental health providers. This study examined the MHADRO's effect on patient outcomes, health care utilization, and oncology provider documentation and behaviors. METHODS: 836 patients were part of a multi-site RCT and assessments were conducted at baseline, 2, 6 and 12 months. RESULTS: The intervention group engaged in less emergency calls to providers. There were no differences in psychosocial outcomes at follow up assessments. Providers of patients in the intervention group were more likely to: document psychosocial symptoms and history; refer to psychosocial services; encourage support groups; seek psychological evaluations during visits. Patients who agreed to a mental health referral had decreased hospitalizations, increased mental health care interactions, and stronger ratings of counseling potential benefits. This group also reported increased psychosocial distress at all follow-up assessments. CONCLUSION: The MHADRO may increase access to mental health care, lessen utilization, and improve providers' management of psychosocial needs, but does not appear to impact overall functioning over time. PRACTICE IMPLICATIONS: Providers are encouraged to consider incorporating programs, like the MHADRO, into patient care as they may have the potential to impact screening and management of patients' psychosocial needs.

Integrated Behavioral Medicine in Cancer Care: Utilizing a Training Program Model to Provide Psychological Services in an Urban Cancer Center.

Psycho-oncology has come of age as its own unique subspecialty under the umbrella of oncology, vastly refining our knowledge regarding the psychosocial impact of cancer and fostering acceptance of the psychological underpinnings of the cancer experience, in turn improving the overall quality of cancer care. The importance of integrating psychological practice into the comprehensive treatment of cancer has become readily apparent, and psychosocial support services are increasing in quantity and breadth. It is the aim of this article to present a cogent argument for the proliferation of Integrated Behavioral Medicine (IBM) programs in both inpatient and outpatient clinical cancer treatment centers via an in-depth discussion of a successful IBM program including analysis of program structure, service delivery model and description of clinical services provided, and a longitudinal review of referral trends.

Utilization of Behavioral Medicine Services to Refine Medical Diagnostic Formulation in the Face of Uncertain Symptom Presentation.

In the ever expanding realm of cancer care, the psychosocial impact of disease and medical treatments has been garnering increased attention. To address these needs, the integration of behavioral medicine services into inpatient and outpatient medical settings has added a unique resource available to oncologists. Psycho-oncologists may assist providers via the provision of psychological assessment and intervention, supplying valuable consultation to members of the medical team and much needed clinical services to patients. The authors present a complex case in which the utilization of behavioral medicine consultation to clarify the diagnostic picture was critical to identifying underlying anatomic disease.

A pilot study of a single-session training to promote mindful eating.

CONTEXT: Although researchers have not yet examined the applicability of mindfulness for weight-gain prevention, mindfulness training has the potential to increase an individual's awareness of factors that enable an individual to avoid weight gain caused by overconsumption. OBJECTIVE: The study intended to examine the effects of 1 h of mindfulness training on state mindfulness and food consumption. METHODS: The research team performed a pilot study. SETTING: The study occurred at an urban, northeastern, Catholic university. PARTICIPANTS: Participants were 26 undergraduate, English-speaking students who were at least 18 y old (77% female, 73% Caucasian). Students with food allergies, an inability to fast, or a current or past diagnosis of an eating disorder were ineligible. INTERVENTION: Participants fasted for 4 h. Between the third and fourth hours, they attended a 1-h session of mindfulness training that integrated three experiential mindfulness exercises with group discussion. Following training, they applied the skills they learned during a silent lunch. PRIMARY OUTCOME MEASURES: The Toronto Mindfulness Scale (TMS), the Awareness subscale of the Philadelphia Mindfulness Scale (PHLMS-AW), and a modified version of the Acting with Awareness subscale of the Five-Facet Mindfulness Questionnaire (FFMQ-AW) were used preand posttraining to assess changes in state mindfulness, present-moment awareness, and mealtime awareness, respectively. A postmeal, subjective hunger/fullness Likert scale was used to assess food consumption (healthy vs unhealthy consumption). RESULTS: The study found a statistically significant increase in state mindfulness (P=.002). Eighty-six percent of participants engaged in healthy food consumption. No statistically significant changes occurred in either present-moment awareness (P=.617) or mealtime awareness (P=.483). CONCLUSION: Preliminary results suggest promising benefits for use of mindfulness training on weight-gain prevention in healthy individuals. More research is needed to understand the impact that mindfulness may have on long-term, weight-gain prevention.

Social problem solving and depression in couples coping with cancer.

OBJECTIVE: When one person in a couple has cancer, both members may experience depressive symptoms and may react as an emotional system. However, the variables that influence this depressive system have not been identified. This study examined whether social problem solving, an important moderator of individual cancer-related depression, is related to depression in the couple system. METHODS: Sixty-three couples with one partner diagnosed with cancer completed self-report questionnaires regarding depressive symptoms, social problem solving, and relationship satisfaction. RESULTS: Multiple regression correlations supported the hypothesis that depression occurs in an emotional system (patient depression predicted partner depression and partner depression predicted patient depression). When examining how partner social problem solving impacts transmission from patient to partner, hierarchical multiple regression demonstrated that one social problem-solving component (positive problem orientation) eliminated the prediction of partner depression by patient depression. No other component of partner social problem solving eliminated the prediction of partner depression by patient depression. Partner social problem solving had no effect on whether partner depression predicted patient depression. CONCLUSIONS: Partners with more positive beliefs about solving problems were less likely to experience depression together with the patients. Further investigation into the role of social problem solving in the interpersonal depression system is warranted.