Top researchers equipping students with doctoral-level cancer training

For doctoral students, the path to a psycho-oncology career begins with a focus in health psychology and leads to key researchers.

By Bridget Murray
Monitor staff

For the past two years, doctoral psychology student Susan Aarestad, has been helping women with breast cancer handle the stress of their disease. She links them with social support and medical advice, and advises them about regular exercise, good nutrition and relaxation techniques.

At the same time, she's studying the women's life satisfaction and sense of purpose following breast-cancer surgery.

Meanwhile Georita Frierson, Aarestad's fellow student in the clinical psychology program at Ohio State University (OSU), is assessing women's postoperative sexual functioning and body image.

In addition, both students attend seminars on research design and cancer prevention and control research.

Aarestad and Frierson are getting training that's more specialized than the predoctoral norm, however. That's due to their work with cancer researcher Barbara Andersen, PhD, a professor in OSU's psychology department who runs the Stress and Immunity Breast Cancer Project at OSU's Arthur G. James Cancer Hospital and Research Institute.

Typically, predoctoral training in research and clinical work is quite broad, says Andersen. No graduate programs or predoctoral internships devote themselves exclusively to cancer training, she notes. So most students must wait until the postdoctoral level to find a concentrated cancer focus and ample funding for cancer research.

Nevertheless, for the graduate student who's interested in cancer, there is training to be had--though not necessarily as specialized as Andersen's offerings--through a grounding in the content area of health psychology along with focused practica, dissertation research or predoctoral internships involving behavioral researchers, she says.

"A lot of the cancer centers are scrambling to bring in prevention and control people, so you'll often have a behavioral type either consulting with them, as I am, or working on staff," she says. "There are a few of us floating around out there, and the savvy students will find us."

Predoctoral research

Students intent on work with cancer patients, or any chronic-illness group, will find the best opportunities by focusing their training in health psychology, according to experts in the field. They recommend enrolling in either a health psychology graduate program or a clinical psychology graduate program with a strong health psychology focus.

Besides a health background, the best means of gaining cancer training is working with cancer researchers, says psychologist and cancer researcher Michael Andrykowski, PhD, of the University of Kentucky College of Medicine. Some resourceful students deliberately enroll in programs for that reason. But many students aren't sure about the patient populations that most interest them until later in their careers. Even then, they often work with a variety of diseases, he notes.

Often students end up working with a cancer researcher because they are interested in health, they "click" with the researcher and the researcher needs their assistance, says Andrykowski, who, with three students, researches breast cancer.

He offers research-training fellowships, also known as assistantships, to doctoral students from the psychology department and other areas. He and his students conduct research on a variety of aspects of coping and adjustment to cancer, including post-traumatic stress disorder in breast-cancer survivors, quality of life in adult bone-marrow transplant survivors and rheumatoid symptoms and menopausal symptoms in breast-cancer survivors. Women's reactions to benign breast biopsies are another research focus. (Even when no cancer is found, the biopsy process is still "stressful and frightening" for many women, Andrykowski says.) Under Andrykowski's supervision, students do their dissertations on aspects of those larger research projects that interest them.

OSU's Andersen uses a similar set up with Frierson and Aarestad, although her research focus differs slightly--looking mainly at the relationship between breast cancer and women's stress levels, immunity and psychosexual functioning.

At other places with a strong psycho-oncology focus--Mount Sinai School of Medicine's Derald H. Ruttenberg Cancer Center being one--faculty often oversee the dissertation research of students from local universities. Usually, students must take the initiative to contact them, says Dana Bovbjerg, PhD, who, along with clinical psychologist Guy Montgomery, PhD, and other faculty, supervise numerous dissertation projects at Ruttenberg.

To bolster students' research skills, some cancer programs also offer seminars. At Kentucky's College of Medicine, for example, students take seminars on research methods and psychosocial aspects of cancer.

Practica

Clinical doctoral students can also opt for a cancer-related practicum, usually found where psychologists run active research projects and work with cancer patients.

For example, the division of oncology at Children's Hospital of Philadelphia offers up to four practicum slots through arrangements with local universities. Among other tasks, practicum students there help rehabilitate children whose radiation treatment has affected their mental functioning.

Pediatric practicum positions are also available in the behavioral sciences section at the Children's Center for Cancer and Blood Disease at Children's Hospital in Los Angeles, affiliated with the University of Southern California School of Medicine.

The practicum offers students a chance to participate in faculty research and develop their own doctoral studies, and it also offers them a choice of three tracks: individual and group psychotherapy, school and social reintegration or neuropsychological assessment. The main focus is meeting the psychological needs of pediatric and adolescent patients and their families.

"Children with life-threatening illnesses tend to be more resilient than adults, especially if they and their families are given adequate psychosocial guidance and support," says Ernest Katz, PhD, director of the hospital's behavioral sciences section. "Trainees with previous clinical experiences with children, teenagers and families have the opportunity to develop consultative skills in a complex medical environment that will serve them well in whichever career directions they pursue."

Katz's practicum offerings are more specialized than the average clinical practicum, however. More typical is a comparatively general practicum in health psychology offered at OSU. It includes work with a number of patient populations, one of which includes cancer.

Internships

Similarly, most predoctoral internships feature broad training that may or may not include a rotation with cancer patients.

An exception to the generalist model is an internship in the Revlon/University of California Los Angeles (UCLA) Breast Cancer Center, affiliated with the UCLA School of Medicine. It's devoted entirely to cancer. Sharla Wells, who currently holds the internship, interviews women newly diagnosed with breast cancer about their levels of stress, coping and family support, and refers them to support groups or professional counseling, as needed.

She also evaluates the health behaviors of women at risk for developing the disease, and points out the need for instruction in breast-cancer prevention strategies and the psychological factors that can impede them. Another of her tasks is helping them understand their motivations for decisions about genetic testing and helping them deal with the consequences of a positive test result.

Wells most enjoys working together with nutritionists, physical therapists, geneticists, radio-oncologists, surgeons and other medical professionals on the complete medical management of patients.

"Together we come up with a treatment plan that fits the patient," she says. "I'm recognizing that prevention is actually treatment."

For more information on health psychology graduate programs and internships, consult "Graduate Study in Psychology" (APA, 1998), and visit the web site of the Association of Psychology Postdoctoral and Internship Centers at www.appic.org.



Read our privacy statement and Terms of Use

Cover Page for this Issue

PsychNET®
© 1999 American Psychological Association

APA Home Page . Search . Site Map