Consultation with Paediatric Teams

Abstract

The increasing complexity of paediatric medical care requires the combined efforts of physicians, nurses and other healthcare professionals. Comprehensive patient care often involves problem solving, which utilizes skills beyond the scope of expertise of one clinician. Gone are the days of the lone physician. The multidisciplinary team is now the tried and tested norm for healthcare provision. Psychosocial professions are increasingly called upon for opinion and intervention in paediatric services. Indeed, paediatric specialties are increasingly purchasing such services directly. There is a range of psychosocial professionals, skilled in providing a variety of therapeutic approaches to meet the needs of the paediatric population. The challenge is to maximize health outcomes and minimize the emotional consequences for all concerned. This article sets out to describe and define the practice of psychosocial consultation to medical teams, from the early stages in observation of the paediatric service to the development of more proactive strategies for full psychosocial integration. The value of consultation is discussed and detailed description is made of the context and structure for delivery of effective psychosocial consultation. The use of the psychosocial meeting for identifying and accepting referrals and, importantly for the supervision of nonpsychologically trained team members, is illustrated with case examples. Finally, the difficulties of the psychosocial role itself within a paediatric multidisciplinary team, and clinical implications for future directions are outlined.