Pediatric oncology consultations: A generalizable model for medical settings.

The traditional medical or disease model of emotional disorders is often counterproductive to establishing an effective psychological consultation service in a medical setting. The reasons for this problem are discussed in relation to the differences between psychological and medical consultants. The development of an effective psychological consultation service in a complex pediatric oncology setting is described in relation to staff and patient needs. The evolution of the consultation service suggests a number of generalizable principles that can be adapted for application in other medical settings. The special nature of this issue clearly indicates that medical settings raise concerns for those who deliver and receive psychological services within them. Unfortunately, the medical model of most hospital consultation services often does not adequately meet the needs of patients or staff for psychological intervention. This article reviews some of the basic reasons for this occurrence and describes the natural evolution of a psychological consultation team that developed in response to consumer demand. Although the specific context is a pediatric oncology service, the model developed and the process of using staff and patient needs to determine the nature of services offered are generalizable to many settings.