Surviving Cancer Competently Intervention Program

Purpose

Surviving Cancer Competently Intervention Program (SCCIP) is a manualized intervention aimed at the dyadic relationship between caregiver and patients by reducing post-traumatic stress symptoms (intrusive memories, avoidance, hypervigiliance), reducing cancer-related anxiety, and improving coping of the patient and family with the cancer experience.

Strategy

This approach integrates family therapy and cognitive behavioral therapeutic approaches. There are a variety of approaches to intervention delivery. The initial strategy involved a one-day high-intensity delivery method. Another recent method of using the SCCIP for newly-diagnosed patients and their families utilized three, 45-minute sessions with three additional follow-up contacts, delivered within 4-6 weeks of diagnosis. Approach may utilize brief Multiple Family Video Discussion Groups.

Target Population

Surviving cancerFamilies of children with cancer and adolescent (11-18 years of age) cancer patients are the primary targets of the intervention. Families typically include mothers and fathers, but in some studies include siblings or secondary caregivers who may be grandparents, partners, siblings or others assisting a single parent. Intervention is suitable for hospital-based or outpatient clinic-based populations. Accrual has been as low as 23% in some studies, possibly due to the high acuity of the patient situation, distance of family home, etc. Improvements in recruitment, targeting most distressed potential subjects, and potentially altering delivery location or model are under consideration.

Research Outcomes

Randomized clinical trials (RCTs) utilizing the intervention have found varying outcomes. In the 2004 (Kazak, Alderfer et al.) study of 150 adolescents and their parents and siblings, fathers showed significant reductions in the intrusiveness of stress symptoms and adolescents had significant reduction in their arousal symptoms; Mothers showed no significant effects of the intervention. A study of intervention at time of diagnosis showed no significant differences between caregiver outcomes depending on arm of the trial in which they were enrolled (Stehl et al., 2009).

Outcomes Research References

Stehl, M.L, Kazak, A.E. , Alderfer, M.A., Rodriguez A., Hwant W.-T., Pai, A.L.H, Boeving A. & Reilly A. (2009). Conducting a randomized clinical trial of a psychological intervention for parents/caregivers of children with cancer shortly after diagnosis. Journal of Pediatric Psychology, 34, 803-816.

Kazak AE, Alderfer MA, Streisand R, Simms S, Rourke MT, Barakat LP, Gallagher P, Cnaan A. (2004, Sep). Treatment of posttraumatic stress symptoms in adolescent survivors of childhood cancer and their families: a randomized clinical trial. Journal of Family Psychology, 183, 493-504.

Kazak, A.E., Simms, S., Barakat, L., Hobbie, W., Foley, B., Golomb, B., & Best, M. (1999). Surviving Cancer Competently Intervention Program (SCCIP): A cognitive-behavioral and family therapy intervention for adolescent survivors of childhood cancer and their families. Family Process, 38, 176-191.

Resources on how to do it: For more information e-mail us or contact Dr. Anne Kazak.