Building and sustaining a comprehensive pediatric oncology care team: The roles and integration of psychosocial and rehabilitative team members

The literature in pediatric oncology has long established, and continues to confirm, that a childhood cancer diagnosis has profound and lasting impacts on pediatric patients and families across functional domains. Running parallel to the medical treatment advances and improvements in survival rates for many childhood cancers is a necessary multimodal approach to the quality of life of these patients and families, including any chronic concerns that arise during or after the completion of cancer-directed care. More specifically, there is a sharpened focus on how cancer affects emotional and behavioral functioning and interrupts the typical developmental trajectory. Lasting familial and financial impacts have been demonstrated as well. To help address these realities, pediatric oncology teams often integrate psychosocial and rehabilitative care services to improve patient and family satisfaction with care, physical health outcomes, and quality of life, including social, educational, and vocational/career attainment. Although pediatric oncology team integration often exists, there remains a need to further describe psychosocial and rehabilitative care teams from a specialty-focused perspective and to explain how these service providers collaborate to best serve patients and families during and after treatment, including the critical roles of promoting lifelong functional outcomes via evidence-based intervention. This work highlights the benefits of ancillary/consulting care services within pediatric oncology, including social work, psychology, neuropsychology, expressive therapies, child life, chaplaincy, teachers/school liaisons, rehabilitation therapies (occupational therapy, physical therapy, speech/language therapy, and audiology services), nutrition, and palliative care. We conclude with discussion of recommendations and lessons learned when integrating psychosocial and rehabilitation services into the pediatric oncology care team, as well as offering directions for future research.