Paediatric Psychology for Parents and Carers

Frequently asked questions

Who is our service for?

We work with children and young people aged 0-18 who are registered with a Telford and Wrekin or Shropshire GP practice and their families. We also have arrangements to see some families from Powys and other areas by prior agreement with commissioners in those areas and where their medical care sits within Shrewsbury and Telford Hospitals.

Our referral criteria state that the primary presenting problem of the person we see relates to their physical health and its impact. Our service is not a mental health provision and children with primarily mental health needs are best signposted to the "Bee-U" Emotional Health and Wellbeing Service (formerly CAMHS) rather than this service. The Paediatric Psychology Service is not able to accept referrals for areas other than the targeted ones listed above.

What type of professionals work for the service - who you are likely to see and why

This service is provided by Paediatric Clinical Psychologists. A Clinical Psychologist is someone who has been trained to help people make sense of their difficulties and think about the best way of dealing with them.

Our service offers a space for young people and their families to talk about how they are feeling and where necessary, suggest strategies or explore ways of dealing with things that can help them to cope better with their situation. We aim to support you through the challenges you are facing by offering well-researched and evidence-based psychological interventions.

Psychologists will not make decisions for you, but will take your difficulties seriously and, where appropriate, offer some help in dealing with them. Clinical Psychologists are not medically qualified. Paediatric Clinical Psychologists have specialised in working with children with physical health challenges. They may have different therapeutic skills and use different approaches, for example, CBT (Cognitive Behavioural Therapy), EMDR (Eye Movement Desensitisation and Reprocessing) or Family Therapy.

We regularly have Trainee Clinical Psychologists on placement with us as part of their training course, all of whom are supervised by a qualified member of staff in the team.

We also have an Assistant Psychologist who has a variety of different roles in the team and helps support families and colleagues, with supervision from qualified psychologists.

Our Office Manager is another key member of the team who will be on hand to help you with queries, arranging appointments and meeting you when you visit the Paediatric Psychology Service for any appointments you may have there.

When we see you

You are likely to first meet a Paediatric Clinical Psychologist during your medical clinic appointments, or after being referred to our service, when you will be contacted directly to discuss how we could help. Our initial discussions will include thinking about what kind of help is wanted or needed, who needs it, and how/where it can take place. We meet with children and families in clinics, in our therapy rooms at our base in Monkmoor, Shrewsbury, or sometimes at home or school if this is appropriate. The service is voluntary so we never arrange to meet people unless they are happy to do so.

When children and young people have serious physical health problems it is often very upsetting and difficult for close family members too. We work with parents, carers, brothers and sisters and other family members to help with coping with the impact of these physical health problems. For example, this may include:

• Helping parents/carers manage the demands of poorly children at the same time as thinking about how their 'healthy' brothers and sisters feel and react
• Helping parents/carers with different ways of coping and to try to keep working together as a couple/team
• Helping individual family members (including brothers and sisters) find a safe, confidential place to talk about what is happening and how it affects them

We also work closely with your medical team to ensure you are getting the best support during difficult transitions, diagnoses and/or procedures.

For more details please see our leaflets on our patient information page.

How we work

We recognise how difficult having a child with a physical health condition can be, for the child and for the whole family, and as Psychologists our role is to help people with how they are feeling. We use psychological theories/interventions, such as talking therapies to help you cope with how you are feeling and the situations you find yourselves in. We provide a safe space to explore your concerns and provide emotional support and coping strategies in order to help you make changes and achieve your individual goals. We can also help you to identify what is typical for a child or young person in these unusual circumstances and what is not and what approaches might be helpful.

We will carry out an assessment to gather all the relevant information about the situation you are in, so that together we can agree on how best we can help you. With your consent, we will also speak to your medical team or other professionals involved in your care, to make sure we have their input and to help them understand the psychological impact of the illness and treatment/s. We will always ask for your permission before doing this.

Though we do not "diagnose" a difficulty, we aim to reach a shared understanding about what is happening for a particular child or family and possible reasons why, by thinking about a whole range of issues, not just the illness. This includes the child’s life experiences in general, their development, temperament, and family/school life. This is known as a psychological "formulation" - a bit like a jigsaw that we build between us, putting all the pieces of information together to form an overall picture. We may take a few appointments to complete the jigsaw and we may adjust the pieces as things change and progress overtime.

As we are embedded within multidisciplinary teams we can help the team to reach a wider understanding of the impact of medical treatment over time and address issues as they arise. We can help the team to think about how to best support your child during different stages of their treatment or during procedures. In addition to seeing you in clinic with the team, we have the opportunity to see you regularly outside of the clinic setting, for confidential psychology sessions to help you to make sense of your experiences and work through any difficulties you or your child are having related to their health condition. We can decide together what information is shared with the wider team afterwards so that everyone works together in a consistent and fully-informed way. This helps everyone feel they have a good working relationship and are pulling together in the interests of the child/young person.

We will work with you until the issue has been resolved and/or you have reached your goals and we agree to bring our work to a close. However, we may also open and close episodes of care as required, as people dip in and out of paediatric psychology input over longer periods of time.

New patients

Children and young people are generally seen following discussion with the medical team(s) that look after them. They can also be referred to our service by their Community Children’s Nurse (CCN).

Children and young people are usually seen with their parents/carers. For older children, the service would need to gain parental consent if they were just to meet the young person on their own. We try to make sure that everyone affected by the illness/condition is involved, if this is helpful and if they wish to be. This includes parents and carers, brothers and sisters, and maybe the wider family as well. We recognise that every child and family is different and we make sure that we are guided by individual needs and preferences, with regular review.

Children needing help with medical procedures

For children that require help in preparing for invasive medical procedures, a discussion with their doctor needs to take place first. If what is required is appropriate, the Psychologist will either provide advice directly to the medical team, or a referral for face-to-face sessions can be made by the professional along with details of the planned procedure and what help is required.

Similarly, when help is needed because a child has severe anxiety about a planned operation or procedure, the medic/team who is planning the operation, their community children’s nurse/school nurse, or sometimes their GP will contact us to discuss whether we are able to help. The discussion will outline the specific details of the procedure and what the difficulty seems to be for the child.

This part of our service is very limited and so we need to ensure that we only become involved if we feel we can be of help. For example, if the operation is not urgent/medically necessary or is voluntary, and the child concerned is declining it, providing our Paediatric Psychology Service support is unlikely to be successful without the willingness of the young person to accept our help. In these circumstances parental advice can be provided (please see resources page). At other times if the child’s medical treatment (and the procedure) is not being done locally but is being carried out elsewhere, it is usually more effective to work with those teams in those specific settings.

Other types of support

The psychologists in the team also work to help and support other professionals in paediatric teams, giving advice, and helping them think about the broader psychological factors that might be impacting on children, young people and their families, so that everyone involved takes into account the "whole picture". Therefore at times the psychologists may be involved "behind the scenes" with the treating team, and not just seeing families face-to-face themselves.

Services we do not offer

The Paediatric Psychology Service is not a mental health provision. Children with primarily mental health needs are signposted to the "Bee-U" Emotional Health and Wellbeing Services (formerly CAMHS) rather than this service. The Paediatric Psychology Service is not able to accept referrals for areas other than the targeted teams listed above (see "Our Services").