Results

Background: As 21st century cancer patients become

more technologically savvy, their need to become more

actively involved in their cancer care allows them to feel

more empowered to take care of themselves physically-

mentally-emotionally throughout their cancer journey. It

is no longer enough to provide cancer-related supportive

care, without augmenting services to actively engage

cancer patients in their own bio-psycho-social-spiritual

self-care and personal growth throughout cancer care.

Methods: A new Behavioral Health Oncology

Consultation Service model was developed to integrate

the bio-medical, psycho-social and spiritual-existential

realms of cancer care as an integrative hybrid approach

to meet the growing needs of the 21st century cancer

patient. This service was built from a PCMH-based

Population Science approach of extending the widest

cancer-care net to the greatest cancer

populations. Receiving direct referrals from Texas

Oncology physicians housed at Baylor Sammons Cancer

Center for all cancer diagnoses + stages, the Behavioral

Health Oncology Consultant provides time-limited cancer-

focused bio-psycho-spiritual-existential supportive care to

promote overall HR-QoL and well-being. Based on a

three-pronged hybrid infrastructure, the service integrates

three primary interventional treatment models:

1) Integrated Behavioral Health Consultation model

providing cancer-related healthy lifestyle

management;

2) Psycho-Oncology model providing cancer-related

psycho-social supportive care; and

3) Existential-Spiritual Care model providing meaning-

centered/purpose-driven interventions to promote

legacy-building + vital involvement through cancer.

Measures: The Duke Quality of Life questionnaire

[assessing physical, mental, social + general QoL

domains] was administered at each appointment, and the

Schedule of Meaning in Life Evaluation [SMiLE] was

administered at the initial evaluation appointment to

assess patients’ meaning & purpose in life as identified

via demarcated levels of importance + satisfaction.

Discussion

As the multidisciplinary fields of medical oncology and

cancer care continue to grow and innovate based on

new scientific research, treatments + cultural trends,

so, too, must psycho-social supportive services in

cancer care meet the growing needs of its 21st

Century cancer populations. By building an integrative

Behavioral Health Oncology Consultation Service

model that challenges patients to take care of

themselves on bio-psycho-social-spiritual-existential

levels of engagement, patients feel far more invested,

empowered + vitally involved in their cancer journey.

BEHAVIORAL HEALTH ONCOLOGY CONSULTATION SERVICE: Building an Integrative Hybrid Cancer Care Model

to Meet the Growing Needs of the 21st Century Cancer Patient

Shannon R. Poppito, Ph.D. & Donna L. Copher, M.A.Behavioral Health Oncology (BHOPE) Service

Baylor Sammons Cancer Center, Dallas TX

BODY

INTEGRATIVE BEHAVIORAL HEALTH

HEALTHY LIFE STYLE MANAGEMENT

Diet / Exercise Mgmt

Coping & Stress Reduction

Cancer-Related Pain Mgmt

Sleep / Fatigue Mgmt

Mood/Hormone Regulation

MIND

PSYCHO-ONCOLOGY

Cancer-Related Stress Mgmt

Life-Transitional Stress Mgmt

Fear / Worry / Anxiety Mgmt

Demoralization/Depression Mgmt

Mindfulness & Relaxation

Restorative Self-Care

SPIRITSPIRITUAL-EXISTENTIAL SUPPORT

Meaning-Centered Therapy

Purpose-Driven Support

Spiritual / Religious Support

Grief & Bereavement

Post-Traumatic Growth

Vital Involvement

PHYSICAL & MEDICAL

SYMPTOMS

Cancer-Related Pain

Cancer-Related Fatigue

Sleep Disturbance

Anxiety/Worry/Panic

Depression/Sadness

SPIRITUAL DEMORALIZATION

Crisis in Meaning & Purpose

Crisis in Faith & Hope

(Religious/Spiritual Beliefs)

End-of-Life Exploration

Post-Traumatic Cancer Stress

vs. Post-Traumatic Growth

EXISTENTIAL SUFFERING

Death Anxiety

Existential Distress

Existential Guilt

Existential Ambivalence

Existential Isolation

Existential Despair

BEHAVIORAL HEALTH ONCOLOGY SERVICE:

AN INTEGRATIVE HYBRID

BIO-PSYCHO-SOCIAL-SPIRITUAL-EXISTENTIAL

APPROACH

CANCER-RELATED SYMPTOMS & CHALLENGES 43%

13%

14%

5%

5%

4%

3%2%

3% 8%

BREAST = 145

BRAIN = 42

BLOOD = 48

COLO-RECTAL = 16

GI-GASTRIC/PANCREATIC = 18

GYN = 13

LUNG = 10

ORAL, HEAD & NECK = 8

SARCOMA = 10

OTHER = 25

BEHAVIORAL HEALTH ONCOLOGY SERVICEREFERRALS BY DISEASE MANAGEMENT: APRIL 2015 TO OCTOBER 2016

This new Behavioral Health Oncology Service was

launched in late April 2015. Though beset with multiple

significant institutional challenges (e.g., non-existent

psycho-social service infrastructure, institutional divisions

between clinical and programmatic services, no shared

electronic medical record), the service experienced a quick

demonstrative uptake from its inception last year. To date,

the Behavioral Health Oncology Service has grown

exponentially, with more than a 300% increase in oncology

referrals compared to past supportive care services:

Total Referrals = 335

Total appointments scheduled = 1154

Total patient encounters = 964

Total % Cancellations/No Shows = 10.68%

Abstract