PROACTIVE PSYCHOSOCIAL CARE OF BLOOD OR MARROW TRANSPLANT PATIENTS

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.