in many communities. According to the report, From Cancer Patient to Cancer Survivor: Lost in Transition, “There is a wealth of cancer-related community support services available through voluntary organizations, many of them at no cost” (IOM and NRC, 2006:229). These services include, for example, nationwide programs of ACS, The Wellness Community, Gilda’s Clubs, and other organizations that offer community-based services at many sites nationwide (some of these are summarized in Tables 3.2 and 3-3 in Chapter 3). These services also include regional, state, and local programs, such as Cancer Action in Kansas City and Sunstone Cancer Support Centers in southern Arizona (see http://www.sunstonehealing.org/index.htm). This approach does not require physical space or a large staff. It does, however, require that organizations making referrals to other providers do so effectively, and that the referring organization have strong follow-up procedures in place.

Approach 3: Use of Remote Providers of Psychosocial Health Services

When a clinical practice has few staff and limited resources and/or is located where there are few or no psychosocial health care resources, such as in rural or remote areas, the only way to provide psychosocial health services on a frequent and timely basis may be to link patients with remote providers through telephone or Internet access. The NCI report Patient Centered Communication in Cancer Care, for example, notes that “telephone help lines can be a useful source of information and emotional support for patients with cancer” (Epstein and Street, 2007:138), and individuals with a recent cancer diagnosis, for example, often use NCI’s Cancer Information Service to obtain information about cancer treatments in preparation for meeting with their clinician (Epstein and Street, 2007). Even practices that elect to deliver a wide variety of psychosocial health services directly may not by themselves be able to provide all of the services needed by every patient, and may still need to provide links to remote services. For example, despite the well-developed nature and breadth of services it provides, Moores Cancer Center refers many of its patients to CancerCare each month for educational programs and financial assistance.

This alternative may also be preferred by some individuals, even when psychosocial health services are available in their communities. Those with rare cancers may wish to connect with others who have their type of cancer, but find that the rarity of their condition means that this is impossible within their community. Others may simply desire the convenience or anonymity of receiving psychosocial services via the telephone or the Internet in their own homes. Adolescents and young adults who use the Internet routinely for multiple purposes also may prefer this mode of communicating.

Using remote resources to provide psychosocial health services to



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