ABSTRACT
Psychotherapeutic interventions and support may be offered not only to the individual palliative care patient, but also to their families and caregivers. This chapter discusses the indications for counseling, varied models of intervention, issues for therapists, and process challenges in the delivery of the counseling will be reviewed alongside the evidence for effectiveness of outcome. Distress, formal psychiatric disorder, concern about coping, and lack of sufficient social supports are the common indications for counseling. Whether delivered individually to groups, or to families, the provision of information about the illness and its treatment is foundational and a counseling component of all clinical encounters. The core elements of counseling comprise the relationship that is established; the explanatory model of intervention used, the procedure for promoting change, and the healing that in turn induces further benefit. Group therapy is at least as effective as individual counseling, while length of treatment and experience of therapist are pertinent influences on outcome.
