GIPPEC » Projects » 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:

Symptom management and communication with health care providers
Changes in self and relationships with close others
Spirituality, sense of meaning and purpose
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.

CALM in Patients with Malignant Primary Brain Tumors- Congratulations Dr. Ashlee Loughan!

Jun 18th, 2020 Tweet

Congratulations to Dr. Ashlee Loughan on recieving an American Cancer Society Institutional Research Grant (ACS IRG) for her grant proposal entitled," Managing Cancer and Living Meaningfully...

Oct 11th, 2018 Tweet

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...

Jun 5th, 2018 Tweet

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 &...

Nov 9th, 2017 Tweet

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

Aug 8th, 2017 Tweet

“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...

Jun 15th, 2017 Meredith Nelson Tweet

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...

Jun 14th, 2017 Milica Milakovic Tweet

“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...

Mar 9th, 2017 Louise Lee Tweet

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...

Jun 16th, 2015 Katrina MacAlpine Tweet

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. ...

Jun 8th, 2015 Katrina MacAlpine Tweet

“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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Oct 12

Managing Cancer and Living Meaningfully (CALM) Virtual Workshop

October 12th - October 13th Virtual

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...

CALM Training Program

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

Global CALM

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.

To learn more about the Global CALM Program and collaboration opportunities click here.

Global CALM Collaborators

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.

Ontario-Wide CALM Supervision Study

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.