Clinical Psychology Service

There are lots of different reasons for a child or young person, with a diagnosed medical condition, and their family, to come to see a Clinical Psychologist. Children and young people who have been referred will be experiencing difficulties with their thoughts, feelings, behaviours and ability to cope. These difficulties will be as a result of their medical condition and/or will be impacting on their ability to manage their condition. Some of the most common reasons for referral are listed below.

Emotional Distress

Having a medical condition can sometimes make a child or young person feel anxious or scared, either about coming into hospital or about how to cope in daily life. Sometimes there are fears about the future, and how best to manage things. It often takes time to understand and accept a diagnosis or injury. Sometimes there will be feelings of anger, sadness and grief over the changes to life.

Adjustment

Sometimes children can become worried about their treatments, or just struggle to take their medication. It can take time and energy to stick to a medication regime. This can be harder still when it means time away from doing things that are fun or where you feel different or separate from your peers. Sometimes there are changes to how a child or young person looks or feels in their body, and adjustment to this can take time.

Acceptance

At other times it might be hard for a child and family to learn to accept and cope with living with a medical condition. Having a new diagnosis often means a big change to life for the whole family. There can be mixed feelings about these changes.

Trauma

Occasionally children and young people may be affected by traumatic events which have occurred at the time of diagnosis or injury or following complicated procedures. In the immediate aftermath of sudden scary events, distress and anxiety are normal responses. However, sometimes, after a longer period of time, the memory of these events can still trigger feelings of distress and can begin to interfere with day to day functioning.

Parental and Family Support

When a child or young person has become unwell or is given a new diagnosis, or where complex decisions must be made, parents can often benefit from the opportunity to reflect upon events and receive emotional support. We are also aware of the impact that a child with a medical condition can have on siblings within a family. Where possible we try to involve the whole family when offering support and advice.

Procedural Distress

The Play Specialists in the RHC do a lot to support children and young people with worries and understanding procedures but sometimes Clinical Psychology is needed too. Children or young people can often feel very anxious and distressed about having medical procedures, attending clinics or receiving feedback at clinics e.g. some young people with Diabetes feel really worried when attending clinics to discuss their HBA1C levels. This can often mean worry in the lead up to hospital appointments and finding it difficult to relax once they get here. Sometimes this can make them not want to come for procedures or attend clinics, or feel very upset when undergoing treatments.

Our team is made up of:

• Clinical Psychologists
• Child and Adolescent Therapists
• Assistant Psychologists
• Psychology Trainees

Out-patient appointments with the Paediatric Clinical Psychology Service normally take place in the ‘Therapies Hub’ on the ground floor of the Children’s Hospital, also known as Clinic 12 or Clinic 1. If you are an in-patient, appointments will take place in a quiet room on the ward, or in a medical speciality clinic.

Assessment

First appointments will normally last between 45 minutes and an hour when we will meet with you and your parents/guardians. If you are a young person, we will give you the opportunity to meet on your own with the Clinical Psychologist for some of these appointments.

At a first appointment, it is helpful for us to hear all about you, your life, hobbies, school/college/work, friends and family, as well as the background of your medical condition. We will also think together about the difficulties that you have been experiencing, how these are impacting your life and condition, and how you and your family cope.

First appointments involve some talking and listening and sometimes drawing and playing with toys together too.

Follow-up

If it is thought that it would be helpful for you to return for further appointments, this will normally be arranged in the first appointment. Follow up appointments will allow us to get to know you better, formulate your difficulties and come up with a plan for supporting you and your family.

We use a number of different therapies, all of which have an evidence base. That is, we know from research that these can be helpful for children and young people struggling with the same kinds of difficulties as you. These might include, among others:

• Cognitive Behavioural Therapy
• Acceptance and Commitment Therapy
• Solution Focused Therapy
• Compassion Focused Therapy
• Trauma-Focused Cognitive Behavioural Therapy
• Family and Systemic Interventions
• Motivational Interviewing Approaches
• EMDR (Eye Movement Desensitisation and Response)
• Narrative Therapy
• Parenting Approaches
• Guided Self Help
• Group Approaches

Families may be seen on either an inpatient, outpatient basis or a combination of both.

Feedback, Complaints and Compliments

At the end of our work together, you will be asked to complete an Experience of Service questionnaire. The information you provide will be anonymous. This is an opportunity to let us know aspects of your care that you have found helpful or unhelpful.

We also welcome feedback via the Care Opinion website. For information about the NHS Greater Glasgow and Clyde complaints procedure, please visit our Complaints page.

When we meet we will try to come to an understanding together of the things which are difficult for a child or young person and how best to help. We do this through talking and asking questions, but above all listening to what matters to that child or young person. We play games or draw together, to help us get to know a young person better. Sometimes we will ask a young person to keep a diary or chart to record their thoughts, feelings, actions or symptoms. For example – ‘My Emotions Worksheet’.

We use a number of different therapies, all of which have an evidence base. That is, we know from research that these can be helpful for children and young people struggling with the same kinds of difficulties as you. These might include, among others:

• Cognitive Behavioural Therapy
• Acceptance and Commitment Therapy
• Solution Focused Therapy
• Compassion Focused Therapy
• Trauma Focused Cognitive Behavioural Therapy
• Family and Systemic Interventions
• Motivational lnterviewing Approaches
• EMDR (Eye Movement Desensitisation and Response)
• Guided Self Help

Group Work

In addition, we regularly run psycho-educational or therapeutic groups for parents or for young people. Both will have an opportunity to meet with and work with others with similar issues.

Teaching and Training

We contribute as a team to the teaching and training of other multi-disciplinary staff working with children within the hospital. We run regular CPD as part of the NHS Education Scotland Psychosocial Interventions Modules. We also teach students in training to become Clinical Psychologists and therefore have close links with the Doctoral courses at both the University of Glasgow and the University of Edinburgh.

Our page on what to do if your child is worried about coming into hospital has advice and signposts to sources of help and support.

When times are difficult, it is really important for parents to take time out to look after themselves and their own mental health. Below are some resources which may be helpful.

Information leaflets

• Parental Stress
• Helping Children to Cope
• Helping Siblings to Cope
• Early Support when your Child has Complex Needs

Websites

• Breathing Space
• Bereavement Services NHS GGC

We accept referrals from all medical specialities within the hospital. We have an embedded psychologist as part of the following Paediatric Medical Speciality Teams:

• Burns (Supporting Children with Burns)
• Cardiology
• Diabetes
• DSD (Differences in Sexual Development)
• Feeding
• Gastroenterology
• OBPI (Obstetric Brachial Plexus Injury)
• Oncology, Haematology and Stem Cell Transplant
• Pain
• Paediatric Intensive Care
• Renal and Renal Transplant
• Respiratory
• Rheumatology

These pages have information and links to useful resources identified by our team:

• Anxiety
• Deliberate self-harm
• Low mood and depression

These pages have information and links to useful resources for parents and carers identified by our team:

• Anxiety
• Deliberate self-harm
• Low mood and depression