Table 3.

Application of the Stage Model for Psychotherapy Manual Development to the MAC interventionist manual

Section	MAC Interventionist Manual
Overview, description, rationale	• Overview of the goal, theoretical rationale, and structure of MAC • Treatment rationale: Large number of older adults with cancer; High prevalence and under-treatment of anxiety
Conception of the problem	• Description of behaviors and cognitions that drive anxiety • Overview of cognitive behavior therapy • Description of additional techniques: Communication strategies, Problem solving, Acceptance • Application of the CCMSC to MAC • Description of patient/caregiver as primary agent of change
Treatment goals	• Primary goal: Improve patient/caregiver ability to manage anxiety • Secondary goals: Improve patient/caregiver communication and problem-solving skills, ability to accept uncontrollable situations, and relationship quality
Contrast to other approaches	• Similarities/differences from traditional CBT • Description of modifications for older adults and their caregivers • Difference from supportive psychotherapy and psychoanalytic treatment
Specification of defining interventions	• Unique/essential: Coping with cancer and aging, cancer and aging caregiving issues, interventionist education in working with older adults • Essential/not unique: Strong rapport, plan for between session exercises • Acceptable/not necessary: Informal conversation (“chatting”), appropriate clinician self-disclosure • Elements to avoid: Extensive reminiscing, exploration of unconscious processes or defense mechanisms
Session content	• Therapist instructions specific to session content
General format	• Delivered individually over the telephone • Seven weekly sessions, 45–50 minutes each • Limited flexibility across session • Consistent session format: Session plan, review of prior session, new information, take home messages, practice plan, worksheets