be addressed (National Breast Cancer Centre and National Cancer Control Initiative, 2003:212).

The recent IOM publication From Cancer Patient to Cancer Survivor: Lost in Transition includes “behavioral” issues in its definition of psychosocial services, that is

services relating to the psychological, social, behavioral, and spiritual aspects of cancer, including education, prevention and treatment of problems in these areas. (IOM and NRC, 2006:482)

The report addresses the need for behavioral interventions in such areas as smoking cessation, physical activity, nutrition and diet, and weight management. It also reviews the use of complementary and alternative medicine.

The inclusion of behavioral issues is consistent with the scope of issues addressed by the American Psychosocial Oncology Society (APOS) in its mission statement: to “advance the science and practice of psychosocial care for people with cancer … in the areas of psychological, social, behavioral, and spiritual aspects of cancer” (American Psychosocial Oncology Society, undated). The inclusion of these issues is also consistent with the American Psychological Association’s definition of psychology:

Psychology is the study of the mind and behavior. The discipline embraces all aspects of the human experience … “the understanding of behavior” is the enterprise of psychologists. (American Psychological Association, 2006)

However, this definition is not wholly consistent with a definition of behavioral medicine that conversely subsumes psychosocial issues:

Behavioral Medicine is the interdisciplinary field concerned with the development and integration of behavioral, psychosocial, and biomedical science knowledge and techniques relevant to the understanding of health and illness, and the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation. (SBM, 2006:1)

NIH notes that “there has been a lack of definitional clarity to several concepts and terms such as palliative care, end of life care, and hospice care” (NIH, 2004:3). In its review of definitions of psychosocial services, the committee also found a similar need for better definitional and conceptual clarity regarding “psychosocial services.”

Conceptual Framework

The committee sought to use a definition that had a conceptual and empirical basis. Conceptual frameworks considered included (1) the list of “psychosocial and environmental problems” contained in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental



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