Table 2.

Application of the CCMSC model to intervention materials

Domain	Components	Intervention Characteristics
Contextual	• Interdisciplinary medical context • Caregivers may play a large role in patient care • Patient and caregiver distress interdependent • Shrinking social networks	• Teaches strategies for effective communication • Teaches strategies for communicating with the medical team • Treatment of caregiver distress • Includes strategies for increasing social interactions
Cohort-based	• Lower levels of education • Less familiar with psychotherapy • Greater stigma toward psychotherapy • Paternalistic view of medical providers	• Manual uses simple language and case examples • Provides basic information on psychotherapy • Normalizes anxiety in the context of cancer • Uses a collaborative model between patient and therapist
Maturity	• Cognitive slowing • Slower processing speed • Memory impairment • Expertise and values developed over a lifetime	• Information is presented in small pieces • Therapy proceeds at a slower pace • Material presented visually and orally • Teaching aids used (e.g., binders, worksheets) • Between session exercises to promote repetition • Review prior session content to “bridge” sessions • Integrates personal values and expertise • Utilizes individual strengths to manage anxiety
Specific challenge	• Reduced mobility • Sensory impairment • Lower energy levels • Cancer diagnosis	• Telephone-delivered sessions • Manual is easy to read • Sessions focus on the most important elements • Content addresses unique stressors caused by cancer (e.g., prognostic uncertainty, rational thoughts about death)