Psychological services

While many people find their own way of dealing with health-related difficulties, very often a little support at times of change when dealing with new and sometimes difficult situations, will prevent other problems from happening later.

We work with a wide range of patients in a number of specialty areas including:

Paediatric Oncology

Psychological support is an important part of the overall care for children, young people and families at Gloucestershire Hospital Trust.

Psychological services are an integral part of both paediatric, and teenage and young adult cancer services. The aim of the service is to provide specialist psychological interventions for children and young people from 0 until their 24th birthday, who have a cancer diagnosis. Psychological support can also be offered to members of their family affected by the diagnosis. Common reasons for referral include adjustment to the diagnosis, anxiety, anger, difficulty taking medication/s, low mood, changes in relationships, school/college worries, coping after treatment has finished and living with uncertainty.

If a cancer diagnosis is recent, it is advised to allow for a period of adjustment before making a referral to clinical psychology. Children, young people and their families can be seen on an outpatient basis, via telephone, video call or face to face at Gloucestershire Royal Hospital or Cheltenham General Hospital, or they can be seen whilst they are an inpatient.

Brain Injury

Read more about the Brain Injury service

Chronic Fatigue Syndrome (ME/CFS) service

The specialist ME/CFS service for Bristol, North Somerset and Gloucestershire is based at Southmead Hospital. A small satellite service runs at Gloucestershire Royal Hospital. For further information, including GP referral criteria, please visit Bristol M.E. Service

Cancer and Palliative Care Psychology Services

The Cancer and Palliative Care Psychology Services are a small team of clinical psychologists based across Cheltenham General and Gloucestershire Royal Hospitals. Our services are part of the broader cancer and specialist palliative care services in the Trust, and help people cope with, and adjust to, the emotional and psychological difficulties associated with cancer. We also see people known to the Community Specialist Palliative Care Team.

It is common for people who are dealing with the diagnosis, treatment, or after-effects of cancer or life-limiting conditions to feel distressed. Many people cope with these as they have done through previous challenges or adversity and with the support of friends, family and peers, as well as support from organisations such as Macmillan, Maggie’s, Charlies and many others. Most people also find support in the expert care of their doctors, nurses and other healthcare professionals, and particularly their clinical nurse specialists, who are also specifically trained in psychological support.

Sometimes, however, when people experience distress that is hard to manage additional input from psychological care specialists can be useful.

Our input is available to people with any cancer diagnosis across the cancer trajectory, from diagnosis, during and after treatment and approaching the end of life. Similarly, we see people with non-malignant conditions who are known to the Specialist Palliative Care Team. Whilst people can struggle at different points of their care, the sorts of difficulties we often help people with can include:

• Anxiety, panic or worry that is hard to manage
• Feeling low or depressed or angry much of the time
• Difficulties making decisions about, or coping with treatments
• Relationship difficulties or body image difficulties
• Talking to children about a diagnosis
• Coping with adjustment, change and loss
• Coping with pain, discomfort, fatigue and treatment side-effects
• Managing complex mental health issues alongside treatment.

Our sessions are usually either face-to-face or by video call, or they can be on the phone when neither of these options is possible. We routinely offer short-term intervention and the number of sessions will be agreed upon with you.

How to refer:

Any healthcare professional involved in your cancer care or part of the Specialist Palliative Care Team can make a referral for you, and your Clinical Nurse Specialist is usually the best first port of call to discuss this. Unfortunately, we cannot accept self-referrals for new patients. Please see the leaflet below regarding our services for more information.

Pathway

Cancer and Palliative care services

Linc Haematology Psychology Service

The Linc Haematology Psychology Service provides a dedicated service to the haematology multi-disciplinary teams to support in and outpatients, close family members and carers who are coping with significant psychological difficulties associated with the diagnosis and treatment of haematological cancers. This includes helping patients and families prepare and cope with the psychological impact of bone marrow transplantation.

Distress is not uncommon for people affected by a haematological diagnosis who may be undergoing intensive treatments and / or coping with the after -effects of treatment and having to adjust to significant life changes. Many people cope with these as they have done through previous challenges or adversity and with the support of friends, family and peers, as well as support from organisations such as Macmillan, Maggie’s, Charlies and many others. Most people also find support in the expert care of their doctors, nurses and other healthcare professionals, and particularly their clinical nurse specialists (Clinical haematology) who are also specifically trained in psychological support.

Sometimes, however, when people experience distress that is hard to manage additional input from psychological care specialists can be useful. Whilst people can struggle at different points of their care, the sorts of difficulties we often help people with can include:

• Anxiety, panic or worry that is hard to manage
• Feeling low or depressed or angry much of the time
• Difficulties making decisions about, or coping with treatments
• Relationship difficulties or body image difficulties
• Talking to children about a diagnosis
• Coping with adjustment, change and loss
• Coping with pain, discomfort, fatigue and treatment side-effects
• Coping with long in-patient stays
• Managing complex mental health issues alongside treatment.

Our sessions are usually either face-to-face or by video call, or they can be on the phone when neither of these options is possible. We routinely offer short-term intervention and the number of sessions will be agreed upon with you.

How to refer:

Any healthcare professional involved in your haematological care can make a referral for you, and your Clinical Nurse Specialist is usually the best first port of call to discuss this. We also accept self-referrals through Linc’s website (Linc Psychology Team - Linc Charity). Please see the leaflet below regarding our services for more information.

Stroke

The Stroke Psychology Service supports stroke survivors across their recovery journey. We work in multi-disciplinary teams from initial admission to the hyper acute stroke unit (Hatherley ward), to longer-term rehabilitation services in the community. Psychologists from our department input to Gloucestershire Health and Care NHS Trust (GHC) stroke services to provide a consistent pathway during the recovery journey. Stroke Psychology support is available at:

• Hatherley ward and Woodmancote ward, Cheltenham General Hospital
• Vale Community Hospital Stroke Unit – GHC service
• Early Supportive Discharge (ESD) team – GHC service
• Community Neurology Service (CNS) – GHC service

We use a neuropsychological approach to support stroke survivors and their carers who are experiencing psychological difficulties related to their stroke, which may include cognitive, emotional or behavioural changes. We offer neuropsychological assessment, neuropsychological rehabilitation, psychological therapy, consultation and training to other members of the multi-disciplinary team, advice and support.

How to refer: If you feel you would benefit from stroke psychology, please ask a member of the stroke team to refer you to the Psychologist within the relevant service.

Neurology

The psychology service to neurology aims to promote the psychological well-being of adults living with chronic neurological conditions and their families. Inpatients and outpatients are seen for assessment and therapeutic intervention.

The neurology service mainly focuses on detailed neuropsychological assessment and the provision of psychological care to people diagnosed with Multiple Sclerosis, Motor Neurone Disease, Epilepsy, Huntington's Disease and Parkinson's Disease. We offer limited psychoeducational input to those with Functional Neurological Disorder, including non-epileptic attack disorder, who are diagnosed and referred by the GHT Neurology team

Clinical services provided include

• Neuropsychological assessment of people with suspected cognitive dysfunction
• Assessment of mental capacity in relation to medical, social, financial or other substantial decisions
• Psychological assessment and support of people (and their families) diagnosed with Multiple Sclerosis, Motor Neurone Disease, Huntington's disease, Parkinson's disease, epilepsy and other neurological conditions
• Treating mood related problems secondary to neurological disease
• Attending ward rounds and multi-disciplinary team meetings
• Staff training in psychological care of neurology patients and supporting nursing staff with management of cognitive, emotional and behavioural difficulties in the acute setting
• For patients with Parkinson’s Disease the 3 session ‘Living with Parkinson’s’ Group provides information and support to patients and carers on managing the psychological aspects of the condition. The course includes session on adjusting to the diagnosis, coping with sleep problems and fatigue and the management of emotional changes including anxiety and depression. In addition a session is dedicated to the understanding and management of potential cognitive problems associated with Parkinson’s.
• For patients with Multiple Sclerosis, an 8 session group, based in Acceptance and Commitment therapy (ACT), which promotes strategies in self-management of the emotional and cognitive impact of MS. It has been designed for individuals who are finding it difficult to cope with the emotional impact of MS, which may have resulted in low mood or anxiety, and individuals who are having difficulties with adjustment to their diagnosis.
• A 2 session psychoeducational FND group
• Running relaxation strategies groups see referral form
• Running memory strategies, single session classes see referral form

Health outcomes are routinely collected to assess the following:

• Reduction in distress
• Increased sense of control (self-efficacy)
• Increased knowledge

How to refer to Neurology Psychology

Referrals can be made by Consultant Neurologists or their clinical teams by letter or by using the referral form and sent to:

Health Psychology Department (Neurology Service), Beacon House, Gloucestershire Royal Hospital

Tel. 0300 422 8523

General and old age medicine

The psychology service to General and Old Age Medicine (GOAM) includes the psychological assessment of, and therapeutic input to, inpatients and outpatients under the care of a GOAM consultant at our hospitals. Patients can, however, be referred by any member of the MDT.

Clinical services provided include:

• Neuropsychological assessment of people with suspected cognitive impairment to inform diagnosis and care
• Assessment of mental capacity in relation to medical, social, financial or other substantial decisions
• Assessment of mood in older adults with health issues
• For patients with Parkinson’s Disease the three-session ‘Living with Parkinson’s’ Group provides information and support to patients and carers on managing the psychological aspects of the condition. The course includes session on adjusting to the diagnosis, coping with sleep problems and fatigue and the management of emotional changes including anxiety and depression. In addition, a session is dedicated to the understanding and management of potential cognitive problems associated with Parkinson’s.
• Therapeutic input for outpatients for those managing a variety of health conditions, such as Parkinson's Disease and dementia, including:

1. Information provision and emotional support
   
2. Individual psychological therapy to support specific issues such as low mood and anxiety, including those contributing to recurrent falls
   
3. Brief relaxation strategies groups to facilitate the development of stress-management techniques referral form attached
   
4. Single-session memory groups to provide information and advice on managing memory difficulties see attached leaflet

Referrals can be made either by letter or by sending the attached referral form to: Health Psychology Department (GOAM Service), Beacon House, Gloucestershire Royal Hospital, by fax: 0300 422 8137 or by telephone: 0300 422 8523

Pain management

The Pain Self Management service is for adults with long-term benign pain. We help people develop strategies to manage their pain to find a better quality of life. The multi-disciplinary team includes nurses, physiotherapists, occupational therapists and psychologists who are based in Gloucester, Cheltenham and Hereford. We use physical rehabilitation cognitive behaviour therapy and mindfulness approaches.

Read more about the Pain Management Service

Renal Psychology Service

The Renal Psychology Service is a small service that sees patients as part of the hospital multi-disciplinary renal team. Similar to the cancer and palliative care psychology services, the renal psychologist works with people where a renal diagnosis or its treatments are having an impact on their psychological well-being. Often there are different challenges at different stages of treatment, and difficulties that the psychologist might work with people on include anxiety, panic, felling low, adjusting to change and loss, managing decisions, side effects, talking to family members and living as well as possible alongside the impact of your condition.

It may be that one appointment is helpful, it may be that a short series of appointments would be too, and you are welcome to bring along family members you would like to join you.

The renal psychologist also works closely with the medical team and, with your permission, may liaise with your consultant, renal nurse or renal dietitian to help them to understand how to provide the best care and support for your needs.

How to refer:

If you would like to meet with the renal psychologist, please ask any member of your renal team to refer you.

Specialist weight management

Read more about the specialist weight management service (SWMS).

Information for prospective students

Who are placements suitable for?

You are welcome to apply, as long as you wish to gain valuable and varied experience towards your career. In particular, we welcome applications from these students who are seeking placements:

• undergraduate BSc sandwich year students - placements wouldn’t be available in 2023.
• postgraduate MSc students
• clinical psychology trainees.

Unfortunately, we do not offer placements to students who are under 18 years of age.

What is my minimum commitment?

We ask for a minimum commitment of 3 months, of at least 3 days per week, in order to be able to offer any meaningful experience. It is common for undergraduate BSc sandwich students to work 4 day weeks, starting in September and ending in June of the following year, (with these placements normally totalling 160 working days).

Unfortunately, we do not offer placements which last fewer than 3 months and 3 days a week.

Which services may offer placements?

• Neurology
• Older Adults
• Stroke
• Specialist Weight Management Service
• Pain Management
• Palliative Care
• Paediatric Diabetes

When and how should I apply?

The deadline for applications is 15th November each year. Please ensure you contact us before this date, sending us a CV and covering letter to Mark Giles and Andrew Champion. Interviews are most likely to be conducted in the second week of January.

Contacts

Dr Julie Highfield, Consultant Clinical Psychologist (Chief Psychological Professions Officer and Head of Psychological Services)

Aileen Thomson, Consultant Clinical Psychologist: 0300 422 8552 (for enquiries relating to older adults, acute stroke, brain injury & neurology services)

Hilly Webb-Peploe, Consultant Clinical Psychologist: 0300 422 8523 (for enquiries relating to palliative care, cancer, haematology, renal medicine)

Kate Crews Clinical Psychologist: 0300 422 8117 (for enquiries relating to paediatric diabetes)

Gail Bohin, Clinical Psychologist (clinical lead for SWMS): 0300 422 8110 (for enquiries relating to bariatric surgery & specialised weight management services).

Referral guidelines

Take a look at our latest referral guidelines to find out who can refer to health psychology.