A stepped model of psychological survivorship care for the cancer services that do not have one.
Systematic supportive care screening at the end of treatment and throughout survivorship, with stepped psychological intervention where it is indicated, across every site, for a fixed cost per patient. Designed and overseen by a senior clinical psychologist, and delivered without adding to your team's workload.
Arrange twenty minutesMichelle Davey, Senior Clinical Psychologist, AHPRA registered. An entire career in psycho-oncology, across Australia and New Zealand.
Treatment ends. The psychological work begins. The contact stops.
Treatment provides structure, frequent contact and a team watching for problems. Survivorship removes all of it at once, at the point the psychological work begins, and the job of interpreting every symptom moves to the patient.
Supportive care needs are supposed to be screened systematically at the end of treatment and throughout survivorship. Those are the timepoints a service cannot cover itself, because by then it no longer sees the patient. Outside the major centres they are not covered at all, because there is no one to do the screening and nowhere to send the results.
This is a design problem rather than a performance one. For a service without direct access to psycho-oncology there is no specialist tier to refer to at all, and no amount of clinical goodwill creates one.
Stratified by presentation, stepped by intensity
- Screening is not one event at one timepoint. Every patient is screened two weeks after treatment ends, then again before every scan and at set intervals for five years, with monitoring in between, so someone whose fear rises months later is picked up rather than waiting to be noticed at an appointment.
- The entry screen uses a validated fear of recurrence measure alongside the Distress Thermometer and Problem List, developed by the National Comprehensive Cancer Network and named in the nationally endorsed Optimal Care Pathways.
- Nobody moves up on a timetable. A patient steps up only where re-measurement shows they have not responded, and moves back across when they have.
- Individual psychology and psychiatry sit outside The Cancer Rollercoaster. We do not provide either. Where a patient needs one, we refer them out, at any point in the pathway rather than only at the end.
The Cancer Rollercoaster is not one-to-one therapy. It is designed to reach every enrolled patient, and to reserve scarce individual care for the people who genuinely need it.
It also does something a referral-based system cannot. It provides skills, structure and connection to the patients who are not obviously distressed, who would never be referred, and who would never ask.
Treatment finishes
Your service sends the patient's contact details. We make contact and obtain consent.
Two weeks after treatment ends
Separates the two presentations that need different content. Not two severities of one problem.
Adjusting to life after treatment
The larger group, and ongoing. Re-screening before every scan and at set intervals picks up anyone whose fear rises later.
Fear of cancer recurrence
A structured self-paced program, then a clinician-facilitated group where re-measurement shows someone has not responded. Where fear is already severe at entry, the group is offered straight away.
Re-screening around every scan and at set intervals, with proactive contact between. A patient whose fear rises is moved back into the fear pathway rather than waiting to be noticed.
Individual psychology and psychiatry sit outside The Cancer Rollercoaster. Where a patient needs either, we refer them out, at any point in the pathway.
What is actually delivered, as distinct from how they move through it
- Psychoeducation written and presented by a senior clinical psychologist, not licensed in and not outsourced
- Live group calls, with the recordings kept and available afterwards
- A private community away from social media, where questions are answered by the psychologist who wrote the material
- Structured programs with workbooks, for the presentations that need them
- Proactive contact if a patient goes quiet, rather than waiting for them to come back
Patients are never charged, and no financial arrangement between us is visible to them.
Your team's entire involvement is the patient's contact details
Treatment finishes, send the details, we take over. There is no eligibility judgement to make and nothing to assess.
What your team does
- Sends the patient's name, mobile and email when treatment finishes
- Receives an enrolment acknowledgement
- Is told when a patient is escalated, or referred on beyond our scope
What your team is not asked to do
- Complete referral paperwork or onboarding documents
- Decide which level of support a patient needs
- Monitor patients or follow them up
- Adopt, learn or maintain any software
- Produce reports. Reporting is provided to you, not required from you
Clinical oversight, ongoing follow-up and clinical risk sit with us. Your standard of care improves while your workload stays where it is.
We refer into your services, not around them
Where a service employs cancer care coordinators, social workers or psychologists, we refer patients into those services as well as out to external providers. The point is the people falling through the gaps. It scales what an existing team cannot reach, and it removes nothing they already do.
What sits behind it
- Designed and overseen by a registered senior clinical psychologist
- Structured screening at entry, re-measurement at each stage gate, and re-screening around every scan for five years
- Defined escalation protocols for distress or risk
- Defined referral pathways out to individual psychology and private psychiatry, neither of which we provide, where a patient's needs exceed our scope
- Informed consent and confidentiality built into onboarding
- Clinical records held in an Australian-hosted clinical record system, with secure data handling and explicit scope boundaries
- AHPRA alignment throughout
The Cancer Rollercoaster operates as an independent provider rather than as your agent, and no patient-level clinical data passes back to you.
The work is evidence-informed. It is grounded in the established clinical approaches to fear of cancer recurrence, and draws on metacognitive therapy, acceptance and commitment therapy, attention training and behavioural activation. It is an educational translation of that literature, not a reproduction of any single protocol.
What comes back to you
- Enrolment acknowledgement
- Notification of clinical escalation
- Notification of facilitated referral out
- Quarterly de-identified reporting, split by pathway stage
That last one is an artefact you can put in front of an accreditation assessor under NSQHS Standard 5, rather than a courtesy.
The first partner sites are being established now
The pathway is being established with a small number of partner sites, measured from the first patient. Founding partners have advisory input on the pathway as it is built, and regional exclusivity for a defined period.
One payment per enrolled patient, covering five years of access. No banding and no volume caps. One decision at the end of treatment, and one fixed cost per patient.
Arrange twenty minutesmichelle@thecancerrollercoaster.com. No proposal and no pricing in the first conversation. Twenty minutes to hear what you are seeing in your service.