In the article below, Osher Research Assistant, Esme Goldfinger, interviews Dr. Daniel Hall, a 2020 graduate of the HMS Research Fellowship in Integrative Medicine. Dr. Hall is a staff psychologist and an Assistant Professor of Psychology in the Department of Psychiatry. He is affiliated with the following centers and programs (listed alphabetically):
– MGH Behavioral Medicine
– MGH Benson-Henry Institute for Mind-Body Medicine
– MGH Cancer Center, Cancer Outcomes Research and Education (CORE) and Survivorship Program
– MGH Mongan Institute, Health Policy Research Center
Dr. Hall treats adults who are coping with chronic or life-threatening illness, such as cancer. He also treats adults who are seeking to change health behaviors, such as sleep/insomnia. Dr. Hall primarily teaches patients skills using cognitive behavioral therapy (CBT), mindfulness meditation, and training in the relaxation response. He also provides clinical supervision to psychology trainees.
Dr. Hall conducts research on how patients experience and manage uncertainty, stress, and health behaviors.
Q: Tell me about your research interests
DH: With an amazing team, I conduct clinical research examining uncertainty, resiliency, and health behaviors (e.g., sleep) among adults affected by cancer and other health conditions. Guided by this work, I also lead clinical trials to test mind-body and behavioral interventions for managing these concerns.
Q: What has been your most exciting or impactful finding?
DH: After completing treatment, 30-50% of cancer survivors report having chronic insomnia that can persist for years. Cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based treatment teaching stimulus control, sleep schedule modifications intended to increase sleep ability and reduce conditioned arousal, sleep hygiene, reframing unhelpful thoughts about sleep, and brief relaxation techniques to help prepare the body and mind for rest. In a 2-phase study, we developed and tested the Survivorship Sleep Program, a synchronous, virtual CBT-I treatment with targeted content for cancer survivors (Cancer, doi: 10.1002/cncr.34066). The program was found to be feasible, acceptable, and associated with large, clinically meaningful improvements in sleep that were sustained by 1-month follow-up. We were excited that a brief program designed specifically for cancer survivors would yield large effects that were sustained one month later, which suggests the promise for a scalable, evidence-based sleep treatment.
Q: How do you hope your research impacts the populations you study?
DH: I hope the interventions that we are developing help survivors of cancer and other chronic illnesses feel more resilient. In one line of work, we are developing programs to help patients feel confident when managing uncertainty in their day to day lives and when engaging in healthcare. In a parallel line of work, we are optimizing behavioral treatment of insomnia to be scalable to a broad, diverse, and growing demographic of cancer survivors. I also believe that fear and sleep management are topics we can all probably relate to! Additionally, leading these research projects has given me the opportunity to mentor graduate trainees, post baccalaureate students, and college undergraduates; I hope these training opportunities will have positive impacts on them and the future of our field!
Q: Can you tell me a bit about what you’re working on currently?
DH: Mind-body techniques, such as cognitive-behavioral skills, mindfulness meditation, and yoga, can help cancer survivors tame their fears of cancer recurrence. In fact, a 2018 meta-analysis of randomized controlled trials found that mind-body techniques are effective in reducing fear of cancer recurrence that persists over time. Moreover, the research showed that the benefits lasted as long as two years. We are currently running a randomized control trial investigating the feasibility and acceptability of a virtual, group based stress management and resiliency training program targeting fear of cancer recurrence in survivors of cancer. Our hope is that participants will find the program useful in managing their fears of cancer recurrence and learn techniques to become more resilient. There are still spots left in the study, so cancer survivors experiencing these concerns can share their information with the Clinical Research Coordinator of the study ([email protected]) or visit the Rally page (https://rally.massgeneralbrigham.org/study/infocus).
Q: What is one question you hope to find an answer to through your research in upcoming years? OR, What lead you to the topics you study today?
DH: Fear of recurrence can affect many patients with chronic illness, not only cancer survivors. Can managing these fears not only provide relief in the face of uncertain recurrence, progression, or exacerbation, but actually foster resiliency? Through future collaborations, I hope to find the common and distinct features of fear of recurrence among a variety of patient populations, including patients living with advanced cancers, rheumatological illness, and Myalgic Encephalomyelitis or Chronic Fatigue Syndrome. Understanding what the similarities and differences in the features of fear of recurrence across different chronic illness groups could highlight what the needs of different populations are, and guide the creation of interventions that target those needs.
- For more about Health Promotion & Resiliency Intervention Research Program (HPRIR), visit: https://www.massgeneral.org/mongan-institute/hprir and/or follow the program on Twitter @mgh_hprir
- Cancer, doi: 10.1002/cncr.34066)
- Cancer survivors experiencing fear of recurrence can inquire about open spots in the clinical trial by writing to the Clinical Research Coordinator at [email protected] or visiting the Rally page at: https://rally.massgeneralbrigham.org/study/infocus.