Patient and caregiver counselling after the intensive care unit: what are the needs and how should they be met?

PURPOSE OF REVIEW: To examine current research on the psychological needs of both patients and their families following critical illness, and discuss how these may be met in a cost-effective manner. RECENT
FINDINGS: Patients and their families have significant psychological problems following critical illness. To date, very few intensive care units have specialist psychological services to help with the aftermath of the illness experience. There are promising simple therapeutic interventions, such as intensive care unit diaries, that may be beneficial, but which require further research at present.
SUMMARY: Currently, there is an awareness of the psychological sequelae of critical illness for patients and their family caregivers, and with this a responsibility to assess and appropriately help those who are unable to manage their distress. The development and application of specialist psychological services after an episode of critical illness, possibly using a stepped care model, is in its infancy. There are a few centres of excellence that are currently employing these resources, but the vast majority of patients and their families are left to cope on their own. This lack of psychological support has important implications for long-term recovery and quality of life following the episode of critical illness.