Chapter 4 presents a brief description of the range of psychosocial interventions that are available, the sites in which they are offered, the providers who offer them, and psycho-oncology education and training opportunities for health-care providers.

Chapter 5 reviews the effectiveness of psychosocial interventions with an emphasis on evidence from randomized clinical trials. The chapter concludes with a discussion of outstanding research issues that need to be addressed.

Chapter 6 characterizes the delivery of psychosocial services in the context of contemporary breast cancer care, describes a number of service programs, and presents evidence regarding use of psychosocial services by women with breast cancer.

Chapter 7 examines barriers to the receipt of psychosocial services, including issues related to access to care and limitations of systems of care.

Chapter 8 surveys ongoing clinical and health services research aimed at improving psychosocial care and outlines research priorities to improve services to women with breast cancer.


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National Comprehensive Cancer Network. 1999. NCCN practice guidelines for the management of psychosocial distress. National Comprehensive Cancer Network. Oncology (Huntingt) 13(5A):113–147.

Shapiro SL, Lopez AM, Schwartz GE, Bootzin R, Figueredo AJ, Braden CJ, Kurker SF. 2001. Quality of life and breast cancer: Relationship to psychosocial variables. J Clin Psychol 57(4):501–519.

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