Establishing a Psychosocial Program Within a Small Pediatric Cancer Center: Overcoming Challenges and Improving Care

Discuss the challenges and successes of starting a pediatric psychosocial program within a small pediatric cancer center one year post-initiation. Psychologist joined an interdisciplinary team of oncologists, nurses, social workers, inpatient and outpatient child life specialists, hospital school teacher, chaplain and school liaison to establish the Cancer Center Psychosocial team. Established pediatric psychology consult service and billing through mental health codes; initiated administration of distress screening to families of children with newly diagnosed cancer; improved school process for patients; expanding services offered to siblings to include support group and mailings; and participating in institution-wide expansion of bereavement support service for families and staff. Descriptive statistics conducted regarding psychological contacts and billing reimbursement. Psychosocial team created and disseminated a Psychosocial Needs Assessment evaluating patient and parent current psychosocial needs. Department is utilizing the PAT 2.0, a screener for assessing psychosocial risk in families of children newly diagnosed with cancer. Interdisciplinary bereavement working group established at Blank and created a bereavement care survey for staff to complete regarding their perception of care provided to families. Psychologist connected with over 50 patients and siblings over the course of the first year out of approximately 450 patients currently being served by the center. Psychosocial needs assessment data collection preliminary analysis reveals that parents and patients do not have outstanding concerns or questions and feel the team is meeting their support needs. Distress screening by the PAT 2.0 reveals that the majority of families report universal or targeted needs. Bereavement survey of cancer center staff revealed that the majority do not feel comfortable caring for a dying patient (60%). Sixty-six percent of staff believes that the service we provide to families after the loss of a child is poor or fair, and 50% of staff feels that staff receive poor or fair support when caring for a deceased or dying patient. The psychosocial service is thriving and meeting the needs of current cancer patients and families due to collaboration across disciplines, motivation and ancillary support. Services are expanding to provide additional coverage to siblings and provide additional bereavement support to patients, families and staff members. Researchers intere