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

Content & Focus: This article considers the role (and potential roles) of practitioner psychologists in contributing to specialist palliative care in the UK, as developed from modern hospice care. Consideration of psychologist roles is situated within an analysis of the current and historical context of palliative care –permitting some suggestions for future development of roles and broader predictions. The article is structured chronologically and examines three key foci across time. The first of these foci concerns cultural and theoretical conceptualisations of death and dying, which influence caring practices and provide a framework for psychological understanding. The second key focus is the development of palliative care as a specialism – and the provision of psychological support within this specialism. The third key focus is the roles and responsibilities of practitioner psychologists: as potential contributors to theory and practice of palliative care. Conclusions: Despite the centrality of psychological support to the ethos of palliative care, psychologists have historically had little involvement in (or influence on) its delivery. Recent policy guidance in palliative care explicitly recognises the particular competencies of counselling psychologists, and identifies ways in which they can contribute to multidisciplinary palliative care, across all levels of psychological need for the dying and their carers in hospice, hospital and community settings.