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:

1. 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)
2. 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