PURPOSE: The authors describe a proactive model of psychosocial care f
or patients undergoing blood or marrow transplantation and their famil
ies. DESCRIPTION or PROGRAM: This program for blood or marrow transpla
ntation patients, developed at the Center for Cancer Treatment and Res
earch, Richland Memorial Hospital, and the University of South Carolin
a School of Medicine in Columbia, South Carolina, involves pretranspla
nt comprehensive psychosocial assessment; development and implementati
on of an individual psychosocial treatment plan; monitoring and medica
l management of neuropsychiatric problems; and psychotherapeutic sessi
ons with a psychiatrist. These functions ate achieved through tile use
of a multidisciplinary psychosocial team and ongoing consultation-lia
ison with the entire blood or marrow transplantation team. CLINICAL IM
PLICATIONS: This positive, proactive model demonstrates significant be
nefit to patients, families, and the blood or marrow transplantation h
ealthcare team. Benefits of this model are derived from psychosocial a
ssessment during work-up, subsequent planning, and communication with
the entire team, thus;allowing early identification of problems and av
oiding escalation and the likelihood of negative outcomes. Less energy
is exerted and less resources expended when problems are resolved wit
h early intervention rather than dth intensive interventions during tr
ansplant. The psychosocial staff members develop strong relationships
with patients and families before transplant, increasing the power of
interventions and receptivity of the patient. The blued or marrow tran
splantation team benefits from the ongoing presence of psychosocial st
aff and the consistency of approaches offered by team members. Atl int
egral part of this approach is teaching psychosocial care to all staff
members and modeling approaches to problems. Other blood or marrow tr
ansplantation centers and centers providing other intensive anticancer
therapies may benefit by adapting this model into the day-to-day care
of their patients.