Psychologists are registered health professionals who are highly trained to support individuals, families, careers and other health professionals in palliative care settings.
Psychologists support the World Health Organisation’s (2011) emphasis that palliative care not only considers physical and medical treatments, but also assessment and interventions to ensure the psychological well being of the individual and the family / carers.
Psychologists are increasing being included in palliative care teams to provide expert psychological assessments and interventions to effectively address often complex psychological issues.
The National Institute for Health and Clinical Excellence (NICE) guidance: Improving supportive and palliative care for adults with cancer (2004) outlined that psychological support services assess and help patients with psychological problems of all types and levels of severity, including:
- anxiety, including adjustment disorders, generalised anxiety states, phobias and panic attacks
- depression, ranging from adjustment disorders to severe clinical depression
- problems with personal relationships, including communication with health and social care professionals
- psychosexual difficulties (such as erectile dysfunction and loss of libido)
- alcohol and drug-related problems
- personality disorder
- deliberate self-harm
- psychotic illness
- organic brain syndromes
The European Association for Palliative Care (EAPC) task force (2010) identified 5 key skills psychologists bring to a palliative care setting, including:
- Psychological assessment
- Psychological therapy for individuals, families and groups
- Consultation, supervision and staff support
A four-level model of professional psychological assessment and intervention has been outlined in the NICE guidelines (2004). This model of care identifies that all medical, nursing and allied health professionals should be able to recognise psychological distress, be competent enough to avoid psychological harm to patients and carers, and interact with patients and families using patient-centred communications and empathic listening skills. Level 2 care requires expert training and competence to undertake screening and problem-solving. Levels 3 and 4 care requires trained and registered mental health experts, such as psychologists and psychiatrist, to undertake diagnosis and psychological interventions for anxiety, depression or complex grief.