Practitioner psychologists in palliative care: Past, present, and future directions

Categories: Research.

According to the Golijani-Moghaddam, “Despite the centrality of psychological support to the ethos of palliative care, psychologists have historically had little involvement in (or influence on) its delivery” (2014).  The researcher furthers his position by noting recent guidance in certain policy areas have both defined useful competencies of psychologists and identified how these competencies could be used to aid the interdisciplinary efforts of palliative care.

Defining Palliative Care

Because of the wide variety of definitions of palliative care, we will advance the definition being used in this study.  In this study, palliative care is defined as having these aspects:

·         Holistic care of patients with advances illnesses

·         Management of pain and other physical symptoms

·         High focus on psychological, social and spiritual support

·         Focus is on providing best quality of life for patients and families

·         Palliative care may be utilized at earlier stages of the illness in synergy with other treatments

Purpose of the Research

This research seeks to gain a comprehensive understanding of the role psychologists have played/have tried to play within the context of palliative care.  It achieves this by analyzing the roles of psychologists in the past and in the present.  Each of these main sections is organized more thoroughly into three sub-categories: death and dying, role of the psychologist and palliative care

 Psychologists in Palliative Care

According to this study, the role of psychologists in the initial stages of implementing palliative care was minimal.  However, trends over the last 15 years make a case the role is expanding (as shown by the creation of schools of psychology in palliative care and enacted policies which have increasingly supported the role of the psychologist in palliative care).  This study states that policies favor the psychologist in a “leadership” position when administering palliative care.

Examination of the Past

Death and dying – This study advances the idea that a general lack of discourse about death and dying can be traced back to the beginning of palliative care, and most likely past that.  Individuals are distanced from death in that it is common for deaths to occur somewhere other than the home.  This means individuals were not as experienced with dealing with death conceptually even in the past.

Palliative Care – The research traces the definition of palliative care back to St. Christopher’s Hospice by Saunders and colleagues in 1967 (Hallenbeck, 2003).  The definition included two points:  (1) control of pain and other symptoms of terminal illness; and (2) psychological, social and spiritual support for both patients and their relatives/carers.

Role of Psychologists – With the emergence of palliative care on a larger scale, roles for psychologists also emerged, these included, “the maintenance of hope and the value of living in the context of terminal illness, patient choice and autonomy in the end-of-life decision making, and the influence of family support on terminal illness.” However, although roles were clearly identified, psychologists did not play an instrumental role in palliative care in general.

Examination of the Present

Death and Dying – When examining death and dying in contemporary society, the researcher advances three key points: (1) people as a society are living longer; (2) the period of disability prior to death is increasing; and (3) medically – prolonged life may negatively impact quality of life.

Palliative Care – Palliative care is positively correlated with patient death at home as opposed to a different setting.  According to Ons, although 81% of terminally ill patients express a strong wish to die at home, only about 49% actually do (2013).  Palliative care is associated with keeping a patient at home longer because of the support it provides.  However, there is room for improvement.  Many calls received by rapid-response palliative care teams ask for help with psychological distress support.  Psychological stress in a patient can lead to the patient not being able to manage in a home-care setting.   The author states that assistance with psychological support is needed and furthermore, psychologists could contribute to this need.

Role of the Psychologists–  The current research highlights that recently, there have been developments in policy guidelines which identify psychologists as being able to assist in many levels of palliative care.  However, according to the researcher, psychologists are not “uniquely qualified” for providing this care.  Currently, psychologists are lacking in the area of palliative care because of the low-involvement with palliative care in previous times.  They still need to become better acclimated to the climate of palliative care.

The Future Role of the Psychologist in Palliative Care

Upon having examined the past and present roles of psychologists in palliative care, the study advances a brief discussion of the possible future role psychologists will play in palliative care.  In 2008, the Department of Health called for research into all aspects of palliative care (Department of Health, 2008).  This call for research could provide another setting in which the psychologist could contribute to palliative care – by conducting the actual research being solicited from the Department of Health in addition to developing theoretical models.  To gain a more thorough understanding of the possible future roles of psychologists in palliative care as advanced by this author, view the full-text study.

Key Findings and Publication Material

This study provided valuable insight into the role of the psychologist in palliative care.  By examining the history and current state of psychologists within palliative care, the research was able to help provide a vision of the future for psychologists wanting to fulfill a role on the interdisciplinary palliative care team.  Although this summary discussed some of possible future roles of the psychologist within palliative care, the full text provides a full and through discussion on the topic.  All readers are encouraged to access the full text using the information provided below:

Author: Nima Golijani-Moghaddam

Publication InformationCounselling Psychology Review. Mar2014, Vol. 29 Issue 1, p29-40. 12p



As a continuing part of NHPCO’s mission to expand access of educational material on the topics of hospice and palliative care available to the public, NHPCO will provide comprehensive summaries on the latest and most influential research in the field today.  All findings, facts and figures are accredited to the original author(s).  We encourage readers to investigate the full text of these studies. Information on where to acquire the original text will be provided at the end of the summary.


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