Establishing a clinical psychology service at the Interregional Children’s Oncology and Hematology Center of the Yekaterinburg Regional Children’s Hospital
Support
Health care
Beneficiaries
- patients at the Children’s Oncology and Hematology Center
- their parents
- hospital staff
Project working language: Russian
Time frame: since 2012 till now
Status: active
Updated: 02.12.2019
Contact details
Yulia Nutenko
Director, Children of Russia Foundation
E-mail: deti99@mail.ru
Tel.: +7(343) 278 73 50
Project web-site
https://russiankids.ru/
Social challenge and reasons for project’s initiation
Immediacy of the social problem
The project was initiated to address a serious social issue facing the doctors and patients at the Children’s Oncology and Hematology Center. Treatment at an oncology center means extreme stress for children and their parents. One mother who had a child being treated at the center even required urgent medical assistance. She could not cope with depression. This situation made it clear that people undergoing treatment at the center need not only oncologists and hematologists but also therapists.
External reasons for project’s initiation
Making clinical psychologists available at oncological centers for children and adults is a widespread international practice. Such services are also available to Russian patients in Moscow and Saint Petersburg. Yekaterinburg was one of the first cities in Russia, apart from Moscow and Saint Petersburg, to create its own clinical psychology service, drawing on the experience of the two capital cities and other countries. Service chief Tatyana Maiburova consulted with colleagues to collect the best practices in Russia and worldwide.
Internal reasons for project’s initiation
The project is financed by Ural Mining Metallurgical Company (UGMK) and implemented by the Children of Russia Foundation.
The Children of Russia Foundation (https://russiankids.ru) was established by Ural Mining Metallurgical Company in 1999. UGMK CEO Andrei Kozitsyn is the founder and president of the foundation.
The Children of Russia Foundation created the clinical psychology service at the Yekaterinburg Children’s Oncology and Hematology Center in 2012. The project consolidates efforts by government and private organizations.
Target audience and stakeholders of the project
The clinical psychology service successfully meets the needs of the target audience: children, parents, doctors and other hospital staff.
Mission and goals
- Help children go through treatment
- Help parents cope with the trauma of their child’s illness and their long stay in the hospital
- Help doctors avoid occupational burnout
Coverage
Yekaterinburg
Project description
Treatment means IV drippers, blood tests, exhausting therapy, blood, tears and pain. A large number of doctors are fighting for a child’s life. One would think, what can a psychologist do in this situation? Yet psychologists can help at almost every step of the way here. Psychologists help children adopt a proper view of their illness, help mothers accept their children’s illness, help children redirect their resources from dysfunctional defenses to recovery.
When Yulia, 15 yo, checked into the hospital with her mom with an acute lymphoblastic leukemia diagnosis, it was psychologists who taught them not to make any plans, not to think about all the what-ifs. They taught Yulia and her mother to fight, here and now. Thanks to their consultations, every day the mother and the girl would only think about one thing: about winning. They were able to beat the disease, and since 2017 they have been regular participants in the Winners Games (a unique athletica event for cancer survivors among children).
It is not just the children in active therapy and their parents who come to psychologists. Children in the remission stage come as well. After a long period of therapy, they often have problems communicating with their peers. Psychologists help the children to make new friends, restore old friendships or find new hobbies.
The clinical psychology service has offered over 5,500 consultations since 2012. The service has skilled professionals, experts in psychological consulting, psychodiagnostics, hospice care and fairy tale therapy.
Our activities are often covered by local media. This helps attract volunteers, improve the overall awareness in society and bust some myths related to children with oncological diseases. Also, media reports help to find new partners.
Russia has about 60 oncology hospitals today. The experience learned in Sverdlovsk Province can be used and replicated in similar hospitals in other provinces.
Support projects
The project has a team of volunteers controlled and regulated by clinical psychologists. The foundation has supported it since 2014. Volunteers organize special events, celebrations, master classes and entertainment for little patients and their families. There are about 25 volunteers, most of them college students. Before leaving, graduates bring in a new generation of students to ensure continuity.
Team and partners
Team
There are five psychologists who provide psychological support for patients and coordinate volunteers. The service is headed by Tatyana Maiburova, member of the National Children’s Hematology and Oncology Society, executive member for Russia at the ISR (International Society of the Rorschach), SPA (Society for Personality Assessment, USA), and vice president of the Russian Rorschach Society.
Partners
In addition to its key partners, the Children of Russia Foundation and the Interregional Children’s Oncology and Hematology Center, the service cooperates with Yekaterinburg’s leading universities. It also has friends among popular local media personalities, authors and musicians. Theaters and artists often are happy to give small performances for children and their parents.
Resources
Financial resources
The project’s budget for 2018 was 2,551,945.89rubles. UGMK annually provides funding for the program.
Human resources
There are 3-5 specialists working full-time at the Center. They all are proper education (degrees in psychology or medicine) and expertise (working experience and advanced training on working with patients in critical conditions).
Technological and material resources
In 2012, the Foundation equipped a psychology office at the Children’s Oncology and Hematology Center and a playing area in the hallway on the third floor. The office is used for therapy sessions and psychological consultations. The playing area is used for psychological decompression, master classes and small concerts.
Material resources required for the volunteer service are provided by the Children of Russia Foundation.
Achieved results
Immediate results
Since 2012, the clinical psychology service has had over 5,500 visits. In 2018, 90 children and 102 adults have visited clinical psychologists at the Center.
Social results
The service regularly receives positive feedback not only from the main target audience, i.e., the patients and their families. Feedback from doctors shows that they have decreased the level of psychological tension and that children and adults are now better integrated into the treatment process. Also, we have noted that since the clinical psychology unit started working at the Center, the number of families requesting funds for treatment in foreign clinics has decreased. More and more, people agree that children’s cancer can be successfully treated in Russia.
We have also seen a response from the professional community. The work of the clinical psychology service is viewed as a major contribution to the development of oncological psychology in Russia. As it develops, we plan to establish a procedure for sharing best practices and training between psychology services, palliative and hospice services and specialists in these areas.
Internal project assessment
Regular intervision sessions are a key element of the clinical psychology service. They help comply with the ethical standards, keeping patients’ personal data within the community of clinical psychologists. Intervision sessions are used to assess the service’s current performance, identify difficulties and prospects, prevent occupational burnout.
Psychologists regularly report to the Foundation, providing detailed information about their work, the amount of consultations and time spent with children and their parents.
External project assessment
External evaluation is performed irregularly because of confidentiality of patients’ personal data and their critical condition. Usually, external evaluation is related to organizing media and public events in order to raise awareness of the situation with children with oncological diseases or to raise money for advanced diagnostic equipment.
External evaluation deals with qualitative indicators, not quantitative ones. Publications about the project are emotional and attract the public’s attention.
Public events organized by the Foundation are another aspect of external evaluation. Since 2017, the Foundation has organized the regional stage of the World Children’s Winners Games, which always attracts a lot of interest. Future Us, a photography contest (https://help-children.net/news/2019/04/10/ne-perestavat-mechtat/) highlighting the subject of children with cancer, also gets a lot of coverage in local media. Such events present the complex subject of children’s oncology to the general public and help with the rehabilitation and social adaptation of the Center’s former patients.
Project’s distinctive features and know – how
This is a long-term project, which is currently in a stage where it is effective and meets the needs of the target audience.
Russia has about 60 oncology hospitals today. The experience learned in Sverdlovsk Province can be used and replicated in similar hospitals in other provinces.
Challenges and solutions
Challenge: There is no extensive experience in Russia with psychological services at children’s oncological centers.
Solution: Learning from colleagues in other countries, Moscow and Saint Petersburg; some regulations were produced in the course of practical work with patients based on general guidelines for clinical psychologists.
Challenge: There are no comprehensive measures for psychological rehabilitation of patients after treatment.
Solution: Holding the regional stage of the World Children’s Winners Games. This is one of the largest and most successful projects for kids who have beaten cancer.
Challenge: The Center did not have an office for consultations or a playing area.
Solution: The Children of Russia Foundation worked with the Center administration to equip an office and a playing area.
“The Children of Russia Foundation established the clinical psychology service at Yekaterinburg’s Children’s Oncology and Hematology in 2012, and the service has been very effective ever since. There are three to five specialists working at the Center all the time. They are highly trained (with degrees in psychology and medicine) and qualified (all of them have prior experience and advanced training on dealing with critical conditions). They interact with other team members (getting involved not only when requested by the patient but also when requested by a doctor, which helps improve interaction between the patient and the doctor, strengthen the patient’s commitment to treatment, and enhance the parents’ involvement in treatment. If necessary, other specialists are brought in.).
The psychologists are versatile (working with both children and parents, performing family therapy, psychodiagnostics, special education, career guidance, reporting for disability boards, etc.). Now that the Center has its own defectologist, we are able to minimize the impact of long-term medication treatment and isolation on children’s attention, intelligence, memory, speech, general development and their academic performance.
Annually, the Center has 250 children undergoing treatment, transplantation and rehabilitation. Psychologists offer over 1,000 consultations a year in various forms, fully meeting the Center’s needs (no request goes unanswered). The specialists also help the staff avoid occupational burnout. We have plans to start working with hospital staff in Balint groups.
The psychology service helps the family believe that they are not alone, that it is easier to go through a difficult period by sticking together. It maintains the link between the ill child and the regular childhood world. It helps the little patients and their parents cope with the illness and long stay at the hospital.”
“The Children’s Oncology and Hematology Center started working closely with the Children of Russia Foundation in December 2011, when we created the clinical psychology service. Since that time, we have been cooperating regularly and effectively, helping our patients and their parents. Highly skilled specialists help the children to cope with painful procedures and anxieties and help their parents to deal with the psychological trauma caused by their child’s illness.
“The primary result is a psychological contact between the patient, their parents and doctors, assistance for parents in making difficult decisions, and eventually helping the patients and their families return to normal life. It is now clear as day that psychological support for children with oncological diseases is a crucial factor in providing top health care services.”
“When we first came to oncology center, my daughter was extremely nervous, and doctors had trouble helping her because of her reactions. But after my daughter had two sessions with Tatyana Maiburova, her behavior changed. She became a totally different person – calm, positive, happy, optimistic. We, adults, also received valuable recommendations from Dr. Maiburova at the very first meeting. She explained to us in detail what we should pay special attention to, what we should prepare ourselves for, what difficulties we should be aware of. Now that my daughter is in remission, we continue coming to Dr. Maiburova for consultations. My daughter had problems at school, because she had an excessive reaction to some comments by her classmates. Sessions with Dr. Maiburova helped her change her behavior and resolve the conflict. Most importantly, Victoria has made some new friends.”
Plans of further development
The Clinical Psychology Service is a long-term project. Having achieved a certain level, it keeps developing. Methodology keeps improving. Researchers find new ways to make psychological help more effective. Introduction of Balint groups, creation of a rehabilitation center and development of methodologies for psychophysiological aspects of oncological treatment will be the next stage in the service’s development. It will require additional financial and administrative support.
In the long term, the Foundation plans to create a rehabilitation center for the children who have beaten cancer and an information center offering materials on psychological support for cancer survivors.
Recommendations
Clinical psychology for children differs greatly from that for adults. Little patients require special protocols. They also require a special approach to psychological support and special training for specialists. This is why the authors of the project recommend learning from UGMK’s experience and introducing similar services in other provinces of Russia.