A basic tenet of hospice/palliative care is the provision of emotional support for the patient/family unit. However, little systematic data is available to document the counselling and psychotherapy which is provided within hospice and palliative care settings. This paper reviews the emotional needs of cancer patients and family members, the psychiatric symptoms which result from unmet needs as well as the response to dying, provides an overview of models of intervention and reviews studies of the effectiveness of hospice intervention. Serious deficiencies are found in the data available to document the counselling and psychotherapy which occurs in hospice programmes and to measure the effectiveness of these interventions. Suggestions for research and future programme development are given.