Psychologists are the mental health professionals who, after social workers, are most likely to be available for clinical consultation and management of psychosocial concerns in patients with cancer and their families.14 They also represent the discipline that contributes predominantly to psycho-oncology research. As of 2005 there were approximately 90,200 U.S.-based members, fellows, and associates of the American Psychological Association (APA), the professional association that represents psychologists, of which nearly 3,000 belonged to the health division (Personal communication, K. Cooke, APA, April 25, 2005).
Undergraduate psychology programs do not routinely include training in psycho-oncology, except as it might occur in conjunction with clinical rotations. Some health psychology graduate programs have faculty members who do research in psycho-oncology, and graduate students in these programs can choose dissertations dealing with oncology issues. Psychology internships are not available in the specialized area of oncology. However, many 2-year post-doctoral fellowships exist that permit training in either research or clinical work alone, or a combination of both. A large number of members of the Society of Behavioral Medicine have their career emphasis in some area of psychosocial or behavioral oncology. They have made major contributions in cancer prevention, cancer control, and lifestyle change, such as smoking cessation.
The APA offers continuing education opportunities for psychologists, although cancer-related offerings are somewhat limited. Of the 60 continuing education courses offered at the 2005 APA meeting, only one deals with cancer (APA, 2005). Although psychologist-specific continuing education in cancer may be sparse, many continuing education offerings that are aimed at psychosocial care providers from other organizations are available, as discussed below.
Psychiatrists with an interest in diagnosis and treatment of comorbid psychological problems and psychiatric disorders are known as consultation-liaison psychiatrists. A subspecialty certification of psychiatry in the care of the medically ill has been established, with the first specialty examinations in psychosomatic medicine as a subspecialty to be adminis-