title: A worldview of the professional experiences and training needs of pediatric psycho-oncologists.
abstract: BACKGROUND
  Thirty years after the origin of the field of psycho-oncology, limited data exist about the work practices of professionals providing psychosocial care to children with cancer and their families.
  
  
  METHODS
  A survey was designed to assess training, work environment, theoretical orientation, services provided, subspecialty areas or areas of special interest, satisfactions, challenges, and continuing education needs of pediatric psycho-oncologists. Members of national and international psycho-oncology organizations were invited to participate in the web-based survey.
  
  
  RESULTS
  Seven hundred eighty-six professionals from 63 countries responded. The sample consisted mostly of psychologists (41%), physicians (20%), and social workers (14%). Approximately half of the participants worked in a designated psycho-oncology unit. Psychologists and social workers provided the majority of psychosocial services. Individual sessions with parents were most common (42%), followed by sessions with children (41%), survivors (36%), families (31%), and siblings (25%). Therapies provided include cognitive behavioral therapy (50%), relaxation (43%), psychodynamic psychotherapy (27%), play therapy (26%), and imagery (23%). Two-thirds reported having appropriate supervision, 37% were conducting research, and only half felt their salary was appropriate. Differences in therapeutic modalities were found by country. Clinicians desire training on clinical interventions, improving communication with medical staff, research, and ethics.
  
  
  CONCLUSIONS
  An international cohort of clinicians providing pediatric psycho-oncology services perform a wide variety of tasks, use a range of therapeutic approaches, and report considerable work satisfaction. Problem areas include professional inter-relations, inadequate supervision, and need for additional specialized training. Opportunity exists for global collaboration in pediatric psycho-oncology research and practices to enhance clinical effectiveness and reduce professional isolation.
authors.affiliation: Behavioral Science Core, Psychosocial Support and Research Program, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA. wienerl@mail.nih.gov
authors.forename: Lori
authors.initials: L
authors.lastname: Wiener
authors.forename: Daniel
authors.initials: D
authors.lastname: Oppenheim
authors.forename: Joanna
authors.initials: J
authors.lastname: Breyer
authors.forename: Haven
authors.initials: H
authors.lastname: Battles
authors.forename: Sima
authors.initials: S
authors.lastname: Zadeh
authors.forename: Andrea Farkas
authors.initials: AF
authors.lastname: Patenaude
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008495:Medical Oncology / Q000592:standards; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D010372:Pediatrics / Q000193:education; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D010818:Practice Patterns, Physicians'; D036301:Qualitative Research; D012737:Sex Factors; D011795:Surveys and Questionnaires