Psychologists in pediatric palliative care: Clinical care models within the United States

Abstract

Objective: To examine the roles of psychologists in delivering pediatric palliative care (PPC) services, barriers and facilitators of psychologists’ involvement in PPC, and strategies to improve psychology integration into PPC. Method: N = 131 PPC professionals (45% physicians, 26% psychologists, 12% advanced practice nurses, 17% other disciplines) employed at hospitals serving pediatric patients across the United States completed an online survey. Results: Most psychologists who provide PPC services are members of a primary team that delivers palliative care independently or in collaboration with a specialized PPC program. Psychologists provide various services within the purview of PPC, including interventions to relieve children’s psychological and physical symptoms, support patient and family decision-making, and address grief and bereavement. Psychologists also commonly provide psychosocial support for health care providers and teach, supervise, and/or mentor trainees in PPC. Findings suggest a range of interrelated factors that influence integration of psychology in PPC, including funding, billing, time, training, institutional/departmental culture, quality of interdisciplinary collaborations, extent of psychosocial provider role differentiation, and perceptions of the value of psychology services. Strategies to improve integration included addressing funding, billing, and reimbursement challenges; expanding training and developing professional competencies for psychologists in PPC; optimizing communication and collaboration between psychologists and other PPC professionals; and conducting research on the value psychologists add to PPC teams. Conclusions: Pediatric psychologists provide a variety of important services to advance holistic care for children with life-limiting conditions and their families. Additional research examining the effectiveness of different models of psychology integration in PPC is warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved)