Meaning-Centered Psychotherapy at Home

Participant Inclusion Criteria:

Nurses (all phases):

• Per self-report, providing direct care services at VNS Health
• Per self-report, fluent in English**
• Per self-report, is age 18 or older

Patients (all phases):

• Per health record and/or self-report, is a patient in the VNS Health home health agency division (post-acute care)
• Per health record and/or self-report, is age 18 or older
• Per health record, has a cancer diagnosis and a rating of ≥ 2 on Symptom Control Scale
• Per health record and/or self-report, fluent in English**
• Has a score of ≥ 4 on Callahan cognitive screener
• Has a score of ≥ 4 on Distress Thermometer (N/A for Training Case Participants)

• Language verification: For both nurses and patients, prior to enrollment, all will be asked the following two questions by a Clinical Research Coordinator (CRC) to verify

English fluency necessary for participation in the study:

• How well do you speak English? (must respond "very well" or "well" when given the choices of Very well, Well, Not well, Not at all, Don't know, or Refused)
• What is your preferred language for healthcare? (must respond English)

Participant Exclusion Criteria:

Nurses (all phases):

• Per self-report, planning to leave position at VNS Health in the next 6 months

Patients (all phases):

• Per health record and/or self-report, has a diagnosis of Alzheimer's, dementia, or other organic brain disorder and in the judgment of the PIs is unable to meaningfully participate.
• Per health record, has impaired decision-making capacity
• Per health record and/or self-report, is permanently placed in a nursing home
• Per health record and/or self-report, is currently receiving Hospice care