DOI:10.6129/CJP.202106_63(2).0006
Chinese Journal of Psychology 2021, Vol.63, No.2, 203-224

Reflective Praxis of Clinical Psychology in Palliative and Hospice Care

Yu-Ting Yang（Department of Psychology, National Taiwan University；Clinical Psychology Center, National Taiwan University Hospital, Taipei, Taiwan）；Yaw-Sheng Lin（Department of Psychology, National Taiwan University）

Abstract

When patients’ conditions become terminal, they often experience a sense of unfamiliarity and alienations at the physiological, psychological, interpersonal, and spiritual levels. Therefore, applying the knowledge and practice of clinical psychology to help them in returning to daily life as possible is a key issue. This article posits that in addition to physical treatment and symptoms control, there is a need for the palliative and hospice care system to emphasize the integration of the psychological, social, and spiritual aspects of the situation, thereby providing holistic care for patients and their family caregivers. A literature review was conducted to present the current status of research and clinical psychological services and to reflect the “biopsychosocial-spiritual” model. This model was then used to understand the needs and situations of “terminal patients” and their “family caretakers,” on which based-empirical studies of holistic clinical psychological interventions are proposed. Subsequently, a reflective critique was employed, proposing that the contributions of clinical psychology to palliative medicine or terminal care are based on the integration of knowledge and praxis through a process of assisting patients and their family members to transition from “having” to “being.” Knowledge as related objects (such as natural or artificial) is the essence of understanding practical activities (praxis). Hence, the process of converting “knowledge” to “being” is to disclose Dasein, the existence of human beings thrown into “being toward death”. This article points out that palliative and hospice care in Taiwan, whether its focus on the stress model or existential approach, based on the outcomes of on-site clinical practice, showing the characteristics of multiple concepts and methods in order to enhance the quality of care. It is the subject act of knowledge as praxis, and theory and practice is not binary, clinical psychology knowledge is the embodiment praxis of palliative care, based on which future issues and suggestions are discussed.

Keywords: anima care, biopsychosocial-spiritual model, clinical psychology, hospice palliative care, stress model