The proper contributions of social workers in health practice

The contribution of psychologists to specialist palliative care

Current approaches to multidisciplinary working in specialist palliative care generally acknowledge the need for psychological care and the contribution of specialist psychological services. Embedded within an integrated approach to care, there has long been a recognition of the psychological needs of patients and their informal caregivers, although there has been less consensus on how these needs should be addressed. Confusion appears to exist regarding the boundaries between psychological support and psychological interventions, and which members of the multidisciplinary team are best qualified to provide them. This article aims to explore the contribution of psychologists and psychological services to specialist palliative care. It offers a conceptual model to help categorize psychological care in hospices and specialist palliative care services. It seeks to help define the boundaries between general psychological support and care that may be offered by nurses and other health care professionals, and the specialist expertise of psychologists.

Bereavement services in acute care settings

Families of acute care patients who die while receiving care face loss and grief in unfamiliar institutional environments. Informal bereavement assistance may occur in acute care settings, but formally organized service and planned follow-up work with bereaved family members is less common. A literature review revealed little discussion of acute care-related bereavement services. The detrimental effects of long-term, unresolved grief, however, are well documented. Bereavement services help to reduce immediate physical and emotional distress while ameliorating long-term morbidity associated with unresolved grief. They may also reduce eventual costs for services and discomfort of illness by reducing the likelihood of stress-related illnesses occurring among survivors. Health care workers such as social workers, psychiatrists, chaplains, and nurses, who are familiar with the psychosocial needs of families and the structure and staffing of these settings, are well-positioned to organize assistance for those experiencing sudden loss. Developing a formal bereavement program in acute care settings involves description of the need, presenting the rationale for the service, identification of program elements, and determination of resource needs. Even in situations in which full services may not be possible, the provision of basic assessment and referral services will be beneficial to survivors while offering the institution several benefits.