Concluding Comments

The newly emerging field of pediatric palliative care offers unique opportunities for psychologists and psychiatrists to participate in enhancing the quality of life of the most vulnerable children and families. Although these professionals have long been represented within medical settings, they remain on the periphery in palliative care, serving more as consultants than as core members of the interdisciplinary treatment team (Bearison et al. 2005; Haley et al. 2003; Nydegger 2008). This is true in adult and, in particular, pediatric settings. Existing discipline-specific training in medicine and nursing, such as the End-of-Life Nursing Education Consortium (see http:// and Education in Palliative and End-of Life Care (see EPEC/webpages/index.cfm), has broadened their curricula to increase their relevance to other professions. Efforts to expand awareness of palliative care within medical school and pediatric residency programs have led to a burgeoning of educational curricula (Bagatell et al. 2002; Sahler et al. 2000; Schiffman et al. 2008). Interdisciplinary training programs, such as those of the Children's Project on Palliative/Hospice Services, National Hospice and Palliative Care Organization, and Initiative for Pediatric Palliative Care, are inclusive of "psychosocial issues" and provide a cohesive framework for understanding the complexity of the field. The critical missing link for the mental health professions is education that focuses on psychiatric diagnoses and intervention in palliative care and hospice settings. The development of such initiatives will result in the increased integration of psychology and psychiatry into pediatric palliative care as the field continues to evolve.

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