Managing Cancer And Living Meaningfully (CALM)

The CALM Intervention

Managing Cancer and Living Meaningfully (CALM) is a brief, semi-structured, evidence-based intervention designed to help people with advanced and metastatic cancer, and their close loved ones, manage the practical and profound problems associated with advanced disease. Reduction of psychological distress and prevention of future distress are the primary goals of CALM.

Developed by Gary Rodin MD and Sarah Hales MD PhD, at the Princess Margaret Cancer Centre CALM, focuses on four content domains that address the practical and profound issues commonly faced by individuals with advanced and metastatic cancer:

  1. Symptom management and communication with health care providers
  2. Changes in self and relationships with close others
  3. Spirituality, sense of meaning and purpose
  4. Sustaining hope and facing mortality

CALM therapy optimally consists of 3 - 6 individual sessions delivered over 3 to 6 months, by a wide range of specially trained healthcare professionals. 

Evidence for CALM

Research conducted over the past decade has shown that CALM is a feasible, acceptable, and effective therapy in reducing and preventing depressive symptoms for individuals with advanced or metastatic cancer. Findings from a randomized controlled trial on CALM, published in the Journal of Clinical Oncology are available here

Please click here for additional publications on CALM.

The Global CALM Program

  Oct 11th, 2018   

The Global CALM Program is an international initiative to train clinicians in CALM (Managing Cancer and Living Meaningfully) therapy, gather evidence about the implementation of CALM in diverse settings, and to make CALM a standard of care for people facing metastatic and advanced cancer.

The Global Institute of Psychosocial, Palliative and...

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Advanced CALM Workshop Concluded

  Jun 5th, 2018   

The largest yet CALM workshop brought together local and international clinicians and researchers with the goal of improving psychosocial care for advanced cancer patients and families with CALM therapeutic framework.

With participants from 9 disciplines and 15 countries, CALM workshop offered a global &...

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Dr. Gary Rodin spoke about CALM therapy

  Nov 9th, 2017   

Dr. Gary Rodin speaks with ecancer at ASCO 2017 about a psychological intervention to help advanced cancer patients manage disease-related anxiety.

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Meet Vera Krejcik, Psychiatry Resident and CALM Therapy Trainee

  Aug 8th, 2017   

I see no reason for my doctor to love me – nor would I expect him to suffer with me. I wouldn't demand a lot of my doctor’s time: I just wish he would brood on my situation for perhaps five minutes, that he would give me his whole...

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Building a Global Network for CALM Therapy

  Jun 15th, 2017      Meredith Nelson

GIPPEC is delighted to announce the successful delivery of six CALM workshops in Chile, Italy, China, New Zealand, and Canada in 2017!  The CALM workshops bring together a diverse group of oncology professionals in psychology, psychiatry, medicine, social work, nursing, palliative and spiritual care, and more, to gain training and...

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Meet Dr. Anne Lanceley

  Jun 14th, 2017      Milica Milakovic

“All great literature deals with the highs and lows of human experience. If you have some resources and perspective yourself on life experience - which literature can offer- it is helpful when dealing with loss and death. Literature also provides the message of choice, human agency and overcoming difficult...

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Registration opens for the CALM Therapy Advanced Training

  Mar 9th, 2017      Louise Lee

CALM or Managing Cancer and Living Meaningfully, is a brief, semi-structured, evidence-based, psychotherapeutic intervention designed to help people with metastatic cancer and their caregivers manage the practical and profound problems associated with advanced disease. The primary goals of CALM are reducing and preventing psychological distress.

The CALM Therapy Training Program is...

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Chloe Shaw awarded 2015-16 GIPPEC Fellowship

  Jun 16th, 2015      Katrina MacAlpine

GIPPEC is pleased to introduce Dr. Chloe Shaw, recipient of the 2015-16 GIPPEC Fellowship.  Chloe will be coming to Toronto from the Institute for Women's Health at University College London, where she currently works as a Research Associate researching end-of-life decision making for critically ill babies on the neonatal unit. ...

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Great Turnout for CALM International Advanced Workshop

  Jun 8th, 2015      Katrina MacAlpine

“The first casualties of cancer are emotional ones. CALM is one way we can help reduce patients’ fears and help them manage what lies ahead.”  Dr. Gary Rodin, GIPPEC Director

The Managing Cancer and Living Meaningfully (CALM) Training Program hosted an advanced CALM workshop in Toronto May 31 –...

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CALM Therapy featured as part of UHN Seried on End-of-Life Care

  Jan 24th, 2015      Katrina MacAlpine

For some couples, third time's the charm.

That's true for Larry and Evelyn Bryan, who met more than 25 years ago working for the same company. She was in product development, he in engineering support. Each had been married twice before.  They fell in love, married in 1989...

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Multi-Disciplinary Research Concepts in Palliative and Supportive Care

The CALM Intervention Managing Cancer and Living Meaningfully (CALM) is a brief, semi-structured, evidence-based intervention designed to help people with advanced and metastatic cancer, and their close loved ones, manage...

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CALM Training Program

The CALM Intervention Managing Cancer and Living Meaningfully (CALM) is a brief, semi-structured, evidence-based intervention designed to help people with advanced and metastatic cancer, and their close loved ones, manage...

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Resources for Palliative and End-of-Life Care for First Nation, Inuit and Metis

The CALM Intervention Managing Cancer and Living Meaningfully (CALM) is a brief, semi-structured, evidence-based intervention designed to help people with advanced and metastatic cancer, and their close loved ones, manage...

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Project Initiatives

The Global CALM Program is an international initiative to train clinicians in CALM therapy, gather evidence about the implementation of CALM in diverse settings, and to make CALM a standard of care for people facing metastatic and advanced cancer.

Global CALM Network

GIPPEC has formed a network of international sites in Europe, Austral-Asia, North and South America. Each site has a CALM lead who is responsible for the implementation of CALM in their centre with the aim of becoming a hub to support training, data collection and the implementation of CALM in multiple sites within their region.

CALM Collaboration Oppertunities 

There are multiple opportunities to get involved in the Global CALM Program at the institutional and therapist level.

Collaborating Institutions

Health care organizations with a cancer program and access to cancer patients can join the Global CALM Program as a clinical site or clinical and research site.  Clinical sites are committed to implementing CALM as a clinical program within their centres. Clinical and research sites are committed to implementing CALM as a clinical program and in conducting research on CALM in their centres. Collaboration Requirements include:  

  • Clinical Site
    • Cohort of therapists (minimum three) committed with dedicated time to achieving CALM therapist certification. Timelines for certification range between 12-18 months. Therapists must be available 2-3 hours per we to see CALM cases and attend supervision.
    • Dedicated CALM site lead committed to developing CALM within the centre and holding a leadership role in CALM. This role may include advocating for CALM within the institution, coordinating supervision with therapists, dedication...
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GIPPEC and the Global CALM Program are proud to have a large network of Collaborators:  

Clinical and Research Collaborators

  • Antoni van Leeuwenhoek Netherlands Cancer Institute, Amsterdam, Netherlands
  • Beijing Cancer Hospital, Beijing, China
  • King Hussein Cancer Center, Amman, Jordan
  • Koo Foundation Sun Yat-sen Cancer Center, Taipei, Taiwan
  • Kyungpook National University Hospital, Daegu, South Korea
  • Alianza Mexicana por el Cancer – MILC, Mexico City, Mexico
  • National Cancer Centre Hospital, Tokyo, Japan
  • National Institute for Health, Bethesda, Maryland, USA
  • Peter MacCallum Cancer Centre, Melbourne, Australia
  • Sheba Medical Center, Ramat Gan, Israel
  • University of Groningen, Groningen, Netherlands
  • University of Hong Kong, Hong Kong, China
  • University Medical Centre Leipzig, Leipzig, Germany
  • University Medical Centre, Hamburg, Germany
  • University of Ferrara, Ferrara, Italy
  • Virginia Commonwealth University Massey Cancer Centre, Richmond, USA

Clinical Collaborators

  • BC Cancer Agency, Vancouver, Canada
  • Instituto Nacional dal Cancer, Santiago, Chile
  • National University of Malaysia, Kuala Lumpur, Malaysia
  • University College London, London, United Kingdom
  • Kings College London, London, England
  • Tom Baker Cancer Centre, Calgary, Canada

Individual Collaborators

  • Champalimaud Clinical Centre, Lisbon, Portugal
  • Fundacion Oncologica Cancer Chile, Santiago, Chile 

If you are interested in learning more about the Global CALM Program, please contact us. 

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Pilot Study Evaluating CALM Clinical Supervision for Clinicians

Study Objectives:

  • We are conducting a pilot study to test the feasibility, efficacy and experience of implementing CALM clinical case supervision, to train oncology healthcare clinicians across Ontario in the delivery of CALM therapy
  • The study will assess clinician-level and patient-level outcomes

Format of Supervision:

  • Clinical supervision will be delivered via small-group videoconference or in-person meetings 
  • Meetings will be held weekly or bi-weekly (depending on clinician availability)
  • Supervision will be led by Dr. Sarah Hales, psychiatrist and co-creator of CALM therapy

Recruitment and Eligibility:

  • We will recruit 20 clinicians from across Ontario, and 40 of their patients, over 2 years
  • Clinicians will be: healthcare professionals who have attended a CALM training workshop, are fluent in English, and are employed in a role where they provide direct clinical care to advanced cancer patients
  • Their patients will be: ≥ 18 years of age, fluent in English, able to provide informed consent, have a diagnosis of metastatic cancer, and suitable CALM therapy candidates

Clinicial Commitment:

  • Participation in weekly or bi-weekly supervision meetings plus delivery of CALM therapy
  • Completion of 2 CALM therapy cases competently under supervision (approx. 6-12 months)

For more information, please contact:

Study investigator Dr. Sarah Hales, at: sarah.hales@uhn.ca, or
Study coordinator Joanna Shnall, at: jshnall@uhnresearch.ca

This research study is being funded by the Ontario Ministry of Health and Long Term Care’s AFP Innovation Fund, and has received Research Ethics Approval from Clinical Trials Ontario.

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