Inclusion Criteria:

- 21 years of age and older

- Able to communicate and understand English well enough to complete assessments and
intervention**

- Patients solid tumors with advanced disease receiving ambulatory care at MSKCC*.

- Distress Thermometer rating of 4 or greater*

- Patients who do not meet these eligibility criteria may be offered participation
as a training case (See inclusion criteria for Training Cases below).

- The study treatment manual materials and assessments were designed and
validated in English and are not currently available in other languages.
Translation of the intervention and questionnaires into other languages
would require reestablishing the reliability and validity of them.
Therefore, participants must be able to communicate in English

Subject Inclusion Criteria- Training Cases

- 21 years of age and older

- Able to communicate and understand English well enough to complete the intervention**

- Patients with solid tumors with advanced disease receiving ambulatory care at MSKCC
with a Distress Thermometer rating of 3 or less. or Patients with solid tumors who do
not meet eligibility criteria for advanced disease receiving ambulatory care at
MSKCC.

or Patients solid tumors with advanced disease receiving ambulatory care at MSKCC who have
participated in a prior meaning focused intervention study.

Exclusion Criteria:

- In the judgment of the treating physician and/or the consenting professional,
presence of significant cognitive impairment (i.e., delirium or dementia) sufficient
to preclude meaningful informed consent and/or data collection.

- Baseline Karnofsky Performance Rating Scale (KPRS) score below 60 or physical
limitations sufficient to preclude participation in a 7 session outpatient
psychotherapy intervention.

- In the judgment of the consenting professional, severe psychiatric disturbance
sufficient that would preclude participation in the intervention (patients whose
psychiatric disorder is well controlled on medication will be eligible).