An investigation of inpatient referrals to a clinical psychologist in a hospice

Abstract

A clinical psychologist, in a new post in a hospice, developed an assessment, therapeutic and consultation role. A retrospective, diary-based audit was made of the inpatients referred during the first 2 years, allowing an examination of referral practices and changes over time as the psychologist's role developed. During the 2 years 11% of the hospice inpatients were referred, consistent with previous published work in this area. Referrals increased from 10% in year 1 to 12% in year 2. Referrals were not skewed in terms of patient gender or diagnosis but younger patients were referred more. Comparison with other studies suggests the psychologist's gender may influence referral rates of woman patients. Referrals for depression and anxiety increased in year 2 but decreased for pain. The number of patients seen with marital/family stresses also increased with time. Such patients required the most psychological input. Patients with problems of alcohol misuse or dementia were particularly challenging for the hospice team and specific training was developed. The psychologist's role is discussed in the light of these findings, particularly in enhancing the multidisciplinary team's holistic approach to the patient and their family, by emphasizing the patient's experience and the collaborative basis of care.

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“…9 They can deal with various kinds of psychosocial issues, including emotional, psychosomatic, behavioral, and family problems. 10 A survey revealed that the most common psychological problems in terminal patients were depression, anxiety, and grief/bereavement, and that clinical psychologists were the first professionals that palliative care programs stated they would wish to hire. 11 However, there were not many clinical psychologists involved in palliative care in Europe in 2012.…”

“…12 Although the number of clinical psychologists has increased slowly, the number of patients and families who receive psychological care from clinical psychologists is still limited. 10,13…”

Couple psychotherapy from an attachment theory perspective: a case study approach to challenging the dual nihilism of being an older person and someone with a terminal illness

“…For example, Alexander (2004) conducted research in a hospice setting. His research demonstrated that younger patients were more often referred to his clinical psychology service than older people.…”

Troubles and Hardships Faced by Psychologists in Cancer Care

“…In many Western countries, particularly in the UK, the role of psychologists has developed as one of assessment, therapy and consulting, within their relatively new post in the hospice setting (4). Consequently, having a psychologist as part of the multidisciplinary team has enhanced the psychological component of palliative care within the hospice setting.…”