Appendix A
Meeting Psychosocial Needs of Women with Breast Cancer

National Cancer Policy Board

Institute of Medicine/National Research Council

Supported by the Longaberger Company Through the American Cancer Society

Monday, October 28, 2002

Describing Psychosocial Services

8:00- 8:30

Continental breakfast

8:30-9:30

Welcome and introduction (Jimmie Holland, Ellen Stovall, and Tom Smith)

Overview: The status of mental health service delivery in the U.S.

• Psychosocial implications of chronic illness

• Delivery of psychosocial services in the U.S.

Speaker: Howard H. Goldman

Overview: Psychosocial interventions for women with breast cancer

• Psychosocial issues throughout the breast cancer trajectory

• Prevalence of psychosocial distress

• Types of interventions and their modes of delivery



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Meeting Psychosocial Needs of Women with Breast Cancer Appendix A Meeting Psychosocial Needs of Women with Breast Cancer National Cancer Policy Board Institute of Medicine/National Research Council Supported by the Longaberger Company Through the American Cancer Society Monday, October 28, 2002 Describing Psychosocial Services 8:00- 8:30 Continental breakfast 8:30-9:30 Welcome and introduction (Jimmie Holland, Ellen Stovall, and Tom Smith) Overview: The status of mental health service delivery in the U.S. • Psychosocial implications of chronic illness • Delivery of psychosocial services in the U.S. Speaker: Howard H. Goldman Overview: Psychosocial interventions for women with breast cancer • Psychosocial issues throughout the breast cancer trajectory • Prevalence of psychosocial distress • Types of interventions and their modes of delivery

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Meeting Psychosocial Needs of Women with Breast Cancer   Speaker: Jimmie Holland 9:30-10:30 Identifying women in need of services: The effectiveness of assessment tools • Discussion of commissioned paper Speaker: Patricia Ganz Reactor: Julia Rowland 10:30-10:45 Break 10:45-12:30 The effectiveness of psychosocial interventions • Discussion of commissioned paper Speaker: Pamela Goodwin Reactors: Katherine DuHamel; Gary Morrow 12:30-1:30 Lunch available 1:30-3:15 Research issues: The need for applied research • Status of research and funding opportunities • Methodological research issues • Research priorities Speaker: Barbara Andersen Reactor: Joan Bloom 3:15-3:30 Break 3:30-5:30 Delivering psychosocial interventions (Presentations from selected programs) Introduction: Ellen Stovall • Psychologist in private practice, Helen Coons • Oncologist in community-based practice, Lidia Schapira, Boston—Beth Israel Deaconess • Managed care-based program (Breast Buddy Program), Ann Geiger, Kaiser Permanente, Southern CA • Cancer center-based program, Richard McQuellon, Comprehensive Cancer Center of Wake Forest University

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Meeting Psychosocial Needs of Women with Breast Cancer   • American Cancer Society programs (Reach to Recovery, I Can Cope, Look Good … Feel Better Program), Bonnie Teschendorf • Community-based program, The Wellness Community, Mitch Golant Discussion Leader: Ellen Stovall Tuesday, October 29, 2002 Overcoming Barriers to Access 8:00-8:30 Continental breakfast 8:30-10:30 Changing provider behavior/practices Introduction: Tom Smith • The structure of breast cancer care • What are the barriers to providing psychosocial services in the current delivery system? • How can care systems be designed to incorporate psychosocial service providers (e.g., multidisciplinary team approaches, links to community-based providers)? Discussion leader: Nina Bickell • The role of guidelines • What is the status of guidelines in the U.S.? • How should they be designed and implemented? • What is the potential for guidelines to change practice? Discussion leader: Roger Winn • Quality assurance • What quality assurance initiatives might be considered to improve the delivery of psychosocial services? • How has measurement of patient satisfaction with breast cancer care within managed care affected practice? • Could indicators of psychosocial care be incorporated into these efforts? • How can national goals for improved psychosocial care be achieved? Discussion leaders: Ann Monroe and Bonnie Teschendorf • Consumer roles and perspectives • How can consumers affect changes in practice? Discussion leader: Christine Brunswick

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Meeting Psychosocial Needs of Women with Breast Cancer 10:30-10:45 Break 10:45-12:30 Improving professional education/training Panel Discussion with Participants: • Who provides (or should provide) psychosocial interventions? • How adequate is their training? • What new training opportunities are needed? • How can we assess the effectiveness of training? Panel: Roger Winn (physician perspective) Jamie Ostroff (psychologist and research perspective) Betty Ferrell (nursing perspective) Carolyn Messner (social work perspective) Discussion leader: Jimmie Holland 12:30-1:30 Lunch available 1:30-3:00 Reducing individual barriers—social stigma, economic, racial, ethnic, cultural, language, and other barriers Speakers: Alicia Matthews • Reducing stigma Carolina Hinestrosa • Reducing barriers to access in the Latina Community Brian Smedley • Briefing on IOM report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” Discussion leader: Jimmie Holland 3:00-3:15 Break 3:15-4:45 Addressing coverage and payment issues • How are psychosocial and mental health services paid for? • How do reimbursement issues limit access to services (e.g., limits set by managed care)? • Are there reimbursement models to emulate? Speaker: Richard Frank (overview)

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Meeting Psychosocial Needs of Women with Breast Cancer   Panelists: -Psychiatrist, David Wellisch -American Psychological Association (APA), Rus Newman -Centers for Medicare and Medicaid Services (CMS), Madeline Ulrich and Ken Simon -Health Insurance Association of America (HIAA), Henry Desmarais -American Association of Health Plans (AAHP), Carmella Bocchino Discussion Leader: Ellen Stovall 4:45-5:30 Wrap-up—Future directions, policy options, recommendations Discussion leaders: Tom Smith and Diana Petitti