“We Need Help!”: Reflections from an Interdisciplinary Team on Embedding a Clinical Psychologist on the Inpatient Palliative Care Consult Service (TH113A)

• Published in: Journal of pain and symptom management Vol. 65; no. 3; pp. e256 - e257
• Main Authors: Zehm, April, Olex, Maria, Taxis, Jacob, Bear, Alexandria
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.03.2023
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2022.12.038

Outcomes: 1. Explore challenges and practical strategies for clinicians and teams providing palliative care to psychosocially complex patients and families in the hospital 2. Describe the unique role and benefits of an embedded clinical health psychologist on an inpatient palliative care consult team Current palliative care guidelines recommend providing psychological care to patients facing serious illness. Clinical psychologists can play a vital role in helping patients cope and make decisions about their care, yet they are often not part of the “core” palliative care team, usually serving in a consultative role instead. In this session, interdisciplinary palliative care clinicians will share their multi-year team experience embedding a clinical psychologist on their inpatient palliative care consult service. Two physicians, a psychologist, and a chaplain will review three challenging clinical cases in which psychology expertise and an intensive, interdisciplinary team approach was crucial to supporting patients, families, or clinical teams. In these situations, serious illness may have exacerbated or precipitated symptoms of anxiety, depression, and trauma. Underlying psychiatric comorbidities, complex social situations, existential and/or spiritual distress, anticipatory grief, issues of adherence, or questions around decision-making capacity further complicated medical care. We will highlight how an embedded psychologist 1) engaged patients and families in therapeutic interventions to address their complex psychosocial, spiritual, or emotional needs; 2) liaised with other clinicians and teams to optimize patient care; 3) offered psychology-informed support to front-line clinicians in the hospital—especially in cases involving team distress, conflict, or challenging patient behaviors necessitating clear management plans; and 4) offered supervision, training, and consultation to other clinicians who required support in coping with the impact of their work or when experiencing difficult issues with patients or colleagues. We will discuss how even patients who are coping well can benefit from joint interdisciplinary clinician visits, engaging in legacy work, or participating in meaning-centered psychotherapy when appropriate. Panel participants will reflect on how the presence of an embedded psychologist has enhanced their palliative care team's capacity to address the emotional needs of hospitalized patients at the same time as other aspects of medical care.