Use and evaluation of psychological interventions in specialist palliative care settings: results of a national online survey with psychologists and psycho-oncologists

Psychologists play a key role as part of the multiprofessional palliative care team. Meaning-, dignity-centred and existential intervention approaches are designed to preserve dignity, strengthen the sense of meaning and alleviate existential distress at the end of life. However, little is known about psychological interventions used in caring for palliative patients and their relatives. This study aims to describe which psychological interventions are used in palliative care, and to what extent professional experience (years working as a psychologist/psycho-oncologist in a palliative care setting), palliative care setting, and further training in palliative care for psychologists influence the use of specific interventions of psychologists. German-wide online survey among psychologists/psycho-oncologists in adult specialist palliative care settings. Psychologists/psycho-oncologists who work in palliative care were recruited by e-mail through palliative care facilities or directly. Ordinal and logistic regressions were performed to examine the influence of professional experience, further training in palliative care for psychologists, and type of palliative care setting on the use of psychological interventions. 105/210 worked predominantly and 66/210 exclusively in palliative settings. 162/205 had further training in psycho-oncology and 36/205 in palliative care for psychologists. Dignity therapy (M = 1.93/elements thereof M = 3.24), meaning-centred therapy (M = 1.63/elements thereof M = 2.79), life review approaches (M = 2.08/elements thereof M = 3.14), or existential therapy (M = 1.37) were used less frequently than cross-school, low-threshold and non-specific interventions like resource collection (M = 6.54), exploration of previous coping strategies (M = 6.24), crisis intervention (M = 6.23) or psychoeducation (M = 5.67). Most common reason were unknown interventions or lack of resources. Professional experience in the palliative setting increased the probability (OR = 1.147, p < .001) of using ‘(hypno)systemic-integrative’ interventions. Use of ‘meaning-dignity-existential’ interventions increased with professional experience (OR = 1.074, p = .045) and further training in palliative care for psychologists (OR = 2.341, p = .044). Despite ample evidence and recommendations, the majority of practitioners seem unaware of meaning, dignity and existential interventions or believe them to be unsuitable in palliative care. Targeted further training and a binding framework concept for palliative psychological care is needed.