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Clinical Manual of Palliative Care Psychiatry

Nathan Fairman, M.D., M.P.H., Jeremy M. Hirst, M.D., and Scott A. Irwin, M.D., Ph.D.

  • ISBN 978-1-61537-061-0
  • Item #37061

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In recent years, palliative care has emerged as the leading model of person-centered care focused on preserving quality of life and alleviating distress for people and families experiencing serious and life-limiting medical illness. Alongside this development has come a growing recognition of the need for expertise in psychiatric diagnosis, psychopharmacology, and psychotherapy within the interdisciplinary team of specialists tasked with identifying and addressing the varied sources of suffering in patients with advanced medical illnesses. The Clinical Manual of Palliative Care Psychiatry was written to motivate and guide readers—whether mental health clinicians or palliative care providers—to deepen their understanding of the psychosocial dimensions of suffering for the benefit of seriously ill patients and the support of their families.

Great care has been exercised in the choice of topics and features:

  • Chapter content emphasizes practical aspects of assessment and management that are unique to the palliative care setting, ensuring that clinicians are equipped to address the most common challenges they are likely to face.
  • Each chapter ends with a list of supplemental materials—including key publications (e.g., Fast Facts from the Center to Advance Palliative Care) and links to relevant modules from the Education in Palliative and End-of-Life Care curriculum (e.g., EPEC for Oncology)—aimed at extending and enhancing reader knowledge of the topics covered.
  • The authors provide thorough coverage of medication use, including off-label applications, which are common in palliative care.
  • A wealth of tables and figures present clinically relevant information in a concise and easy-to-grasp manner.

Practical and brimming with essential information and useful techniques, the Clinical Manual of Palliative Care Psychiatry empowers both mental health clinicians and palliative care practitioners to more skillfully respond to psychosocial suffering in seriously ill and dying patients.


  • Foreword
  • Introduction
  • PART I: Background and Context
  • Chapter 1. Palliative Care 101
  • Chapter 2. Psychiatry in Palliative Care
  • PART II: Core Clinical Applications
  • Chapter 3. Depression
  • Chapter 4. Anxiety
  • Chapter 5. Delirium
  • PART III: Other Common Psychiatric Conditions
  • Chapter 6. Dementia (Major Neurocognitive Disorder)
  • Chapter 7. Insomnia
  • Chapter 8. Substance Use Disorders
  • PART IV: Interventions
  • Chapter 9. Psychotherapy
  • Chapter 10. Pain Management and Psychopharmacology
  • PART V: Pediatric Patients
  • Chapter 11. Children and Adolescents
  • Index

About the Authors

Nathan Fairman, M.D., M.P.H., is Assistant Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of California Davis School of Medicine in Sacramento, California.

Jeremy M. Hirst, M.D., is Associate Clinical Professor in the Department of Psychiatry, Associate Director of Palliative Care Psychiatry, and Associate Director of Patient and Family Support Services at the Moores Cancer Center, University of California San Diego School of Medicine, in La Jolla, California.

Scott A. Irwin, M.D., Ph.D., is Associate Professor of Psychiatry and Director of Supportive Care Services at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, in Los Angeles, California.

With the imperative that psychiatry fully embrace its role among other medical specialties in the management of complex illness, the psychiatric literature is enhanced by timely publications which enhance models of multispecialty care. Drs. Fairman, Hirst, and Irwin have produced a tightly organized, succinct, pragmatic, and current clinical handbook on palliative care psychiatry that is an important contribution to the field. Effectively bridging the relevant areas of psychosomatic medicine and geriatric psychiatry, they show how the consultation psychiatrist is a critical member of the multispecialty and multidisciplinary teams treating patients in a palliative care model. Their chapters cover the critical areas of clinical palliative care psychiatry practice, with especially thoughtfully written chapters on delirium, dementia, insomnia, pain management, substance use disorders, psychotherapy, and the palliative care of children. Their use of tables and figures to illustrate their approach to palliative care patients is especially well done. This book will be of great value to psychosomatic medicine and geriatric psychiatrists, but is equally highly recommended for the general psychiatrist and child and adolescent psychiatrist who will need to care for critically and terminally ill patients as well.—James A. Bourgeois, O.D., M.D., Clinical Professor and Vice Chair, Clinical Affairs, Department of Psychiatry/Langley Porter Psychiatric Institute, University of California, San Francisco

Comprehensive! Concise! Practical! Packed with useful information. The guide I have been waiting for to assist psychiatric residents, psychosocial oncology teams and oncologists in the practice of primary palliative care. Added bonuses are the additional resources and tables at the back of each chapter. This manual is a must read for every clinician dealing with advanced illness and end of life issues.—Mary Helen Davis M.D., DFAPA, Integrative Psychiatry, Behavioral Oncology and Palliative Care Consultant, Associate Clinical Professor of Psychiatry at University of Louisville School of Medicine.

Well-referenced, easy-to-use, and clinically practical, the Clinical Manual of Palliative Care Psychiatry skillfully addresses some of the most challenging aspects of palliative medicine. This book should be in every hospice and palliative medicine physician's library, as well as every psychiatrist who cares for this important patient population. Drs. Fairman, Hirst, and Irwin are leading experts in palliative care psychiatry, and I am thrilled that they have shared their wisdom with us to the benefit of all our patients.—Holly Yang, M.D., MSHPEd HMDC FAAHPM FACP, Scripps Health, San Diego, California

This is a clearly written and evidence-based book on psychiatry in palliative care. Reading this book will go a long way to helping specialist palliative care clinicians feel comfortable dealing with psychiatric illnesses. A must read!—Robert Arnold, M.D., Leo H. Criep, Chair in Patient Care, Chief Medical Officer, UPMC Palliative and Supportive Institute, University of Pittsburgh

The content of the Clinical Manual is extraordinarily expert, well structured, and well presented. The clearly written text, figures, and tables all provide critically important information to the psychiatric and palliative care clinician enabling her/him to rapidly enhance her/his knowledge, clinical judgment, and clinical care delivery.—Deane L. Wolcott, M.D., DLFAPA, FAPM, FAPOS, Director, Oncology Supportive Care Services, Samuel Oschin Comprehensive Cancer Institute, Cedars- Sinai Medical Center, Los Angeles, CA

The Clinical Manual of Palliative Care Psychiatry expertly distills the essential knowledge and wisdom of this growing field in psychiatry. It identifies some of the most critical implicit aspects of working with seriously ill patients and makes them explicit and accessible. This book will be very useful to both psychiatry and palliative care clinicians.—William F. Pirl, M.D., MPH, FAPM, FAPOS, Director, Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital Cancer Center, Associate Professor of Psychiatry, Harvard Medical School, Past-President, American Psychosocial Oncology Society

Clinical Manual of Palliative Care Psychiatry is an important and welcome addition to the growing literature on an aspect of palliative care medicine that is at once a subspecialty and at the same time so universally applicable as to constitute a core competency. This is a very approachable clinical text. Readers will find well-written chapters concluding with key points, practical tables, and figures very useful to those new to the field.—Alan D. Valentine, M.D., Chair, Department of Psychiatry, The University of Texas MD Anderson Cancer Center

Psychiatry is a very valuable but underutilized resource in oncology, palliative care, geriatrics, and long-term care. The frequency of serious psychological concerns is quite high in those with advanced illness and this book is a unique resource that addresses all aspects of suffering and effective treatment. This comprehensive resource on how psychiatry can enhance palliative care should be required reading for all professionals working with the seriously ill and dying.—Dr. Stephen R. Connor, Senior Fellow to Worldwide Hospice Palliative Care Alliance

The Clinical Manual of Palliative Care Psychiatry is a concise and clearly written handbook that will be useful to both psychiatric physicians, advanced practice nurses, and other professionals working at the bedside of patients with serious illness. Intuitively organized, its brief and helpful chapters provide the newcomer with critical overviews, and the more experienced clinician with a framework to be sure he/she has hit all the marks. Fairman, Hirst, and Irwin have done a commendable job of condensing the most up-to-date evidence into a pocket-type guide that should inform and improve clinical care for years to come.—Thomas B. Strouse, M.D., FAPM, DFAPA, Maddie Katz Professor of Palliative Care Research and Education, Vice-Chair for Clinical Affairs, UCLA David Geffen School of Medicine Department of Psychiatry

Drs. Fairman, Hirst, and Irwin's new book, Clinical Manual of Palliative Care Psychiatry, is a critically important contribution to this evolving specialty known as palliative care psychiatry. The eleven chapters are comprehensive yet concise with excellent tables; several chapters are devoted to specific psychiatric complications which practitioners regularly encounter in their clinical work with patients with life-limiting illnesses. Consultation-liaison psychiatry services will find this volume essential for both trainees and senior clinicians who are caring for patients at the end of life.—Jon A. Levenson, M.D., Associate Professor of Psychiatry Columbia University Medical Center, Attending Psychiatrist, Division of Consultation-Liaison Psychiatry, Director, Undergraduate Med Education

This is an exceptionally useful book on the emerging subspecialty of palliative care psychiatry. Psychiatrists who work in psychosomatic medicine, consultation-liaison psychiatry, and neuropsychiatry should make themselves familiar with the concepts in this essential book. It is a welcome addition to the psychiatric literature.—Michael Schrift, D.O., Doody's Book Reviews

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