Psychological Processes in Adolescents Receiving Palliative Oncology Care: Clinical Implications for Multidisciplinary Teams.

PURPOSE: Palliative care for adolescents with poor-prognosis cancer raises distinct and unresolved psychological challenges that differ from the broader adolescent and young adult (AYA) oncology population. This article aims to clarify key psychological processes of adolescents in palliative care and to support multidisciplinary teams in navigating complex behaviors and clinical decision-making.

APPROACH: The study was grounded in developmental and psychodynamic theory and employed a structured reflective methodology to examine emotional, behavioral, and relational dynamics emerging during clinical management. Clinical observations and practices were integrated with current literature on palliative AYA oncology care.

CONCEPTUAL FRAMEWORK: Anticipatory grief (AG) emerges as the primary psychological construct through which adolescents' experiences in palliative oncology care can be understood. It is associated with fragmentation of future perspectives, identity development, and bodily experiences. These processes are illustrated through clinical manifestations, with clear implications for multidisciplinary team practice. Defense mechanisms, along with transference and countertransference dynamics, are also crucial aspects for professionals to recognize and manage. Understanding these elements allows the health care team to provide better emotional containment, navigate relational complexities, and support the adolescent's evolving needs.

CONCLUSIONS

Adolescents in palliative oncology require a distinct psychological framework that goes beyond standard AYA care models. Addressing AG as an organizing process of the adolescent experience calls for greater clinical attention to developmental disruption, relational dynamics, and meaning-making processes. Multidisciplinary teams should integrate reflective and psychologically informed approaches into routine care to improve care quality and clinical decision-making.