Information
Information
Whether you have prior experience of psychological care or not, you may want to understand more about specialist cancer-focused psychological input, to decide whether this could be helpful to you.
All people will have significant psychological reactions to a diagnosis of cancer and its intensive treatments - a highly personal mix of hope, fear and resolve. Everyone will need the care and guidance of their healthcare team, and the support and compassion of their family and friends. Some may also find peer support and guidance from self-help resources very relevant.
Some people may require specialist psychological input, which is clinically advisable when:
The person experiences significant and persistent distress (whether related to cancer or not) that overwhelms their capacity to effectively cope – for example, high levels of anxiety that interfere with sleep, appetite, relationships, work, etc.
There is a previous or current mental health issue (e.g. depression, OCD, addiction), past or recent traumatic experience, neurodiversity (ADHD/Autism) or limited social support, that negatively influence how the person manages cancer treatment and recovery.
When a cancer treatment is likely to impact the patient psychologically (e.g. sense of identity, parenting and other relationships, body image, sexual function, cognition), and the person feels that early psychological input could help them in preparing to cope as well as can be.
The person feels they would benefit from preparation and strategies to cope with medical procedures they find overwhelmingly stressful (e.g. scans, bloods, coming to hospital), or to get the most out of their medical care consultations (e.g. having difficult conversations, resolving issues of trust).
As soon as I receive your inquiry, we will communicate personally and directly over phone or email to find an appointment time that fits with your medical scheduling, typically on a weekday evening. I understand the rapid timelines in cancer and typically will be able to offer appointments within the same week or the following week for video clinic; availability for face-face clinic (Monday evenings) may be further ahead.
While I aim to provide prompt and flexible cancer psychological care, I cannot address urgent mental health crisis needs in this clinic, and in such situations I will always advise contacting NHS 111 or 999 as necessary.
Yes - my patients say that having quick access to an expert psychologist who understands cancer gives them a lot of guidance and comfort, and that a one-off consultation is often enough. They also find it very reassuring to know they can arrange a follow-up anytime they need it, in weeks or months or years ahead, as their cancer treatment and recovery unfolds.
In the initial consultation, I will be listening carefully to establish your priorities and concerns, discuss the cancer and personal context, and identify strengths and challenges. From our interaction, you will get a good sense of whether we have established a warm rapport and ‘fit’, that you are feeling safe to talk openly, as well as a clearer idea of what topics will be useful to focus on.
While many people prefer to have their appointments individually, some may want their partner, friend or carer to join us. This is entirely welcome from my perspective, and I will listen to the other person’s perspective and take it into account when suggesting advice and planning ahead.
From our discussion, we will aim to agree a fully personalized plan, which can include some or all of the following components:
open access to sessions on-request, to process the stress of the cancer experience as it unfolds - this is usually a component of all plans
developing psychological strategies relating to wellbeing challenges of preparing for or undergoing specific cancer treatments (e.g. surgery, hormonal therapies)
sessions focused on identified cancer psychological adjustment challenges - e.g. anxiety in relation to uncertainty (scanxiety), re-adjusting to life after treatment, making difficult treatment decisions, disclosing cancer to children & family, caring for a partner who is struggling, coping with being in hospital, adjusting to body changes from surgery, returning to work, anticipating disease progression, etc.
referrals to other specialists, e.g. psychiatric, neuropsychological, couples work, psychosexual care or interpersonal psychotherapy, where there are particular needs.
targeted signposting to self-management resources that fit your individual needs e.g. reading, app-guided activities, social or peer group activities.
Where we agree there is a need for further input, we can arrange appointments as best fits your specific aims, drawing on a range of psychological models (e.g. ACT, CBT, BSFT, CAT etc).
Our specific focus may require a regular pattern of sessions (e.g. weekly, monthly or quarterly) or may be more appropriate for on-request consultations (e.g. before / after particular anniversaries, treatment milestones or monitoring checkpoints).
Whatever the plan, you can feel fully confident that you will have flexible access to support over the long term, because I really understand that cancer adjustment needs that.
It is good clinical practice to write a brief communication to your cancer consultant and/or referrer after an initial consultation, to appraise them of key points and the agreed plan. However, this is not obligatory and I will be led by your views on what can be shared and with whom - it's okay to keep the consultation fully confidential. The only exception, which is an over-arching legal requirement for all healthcare professionals, is where there is specific and direct risk of harm to the patient or others.
In terms of notes from sessions, I make brief personal notes that are kept separately, securely and confidentially, and are not shared with anyone else. I can also add clinical notes in hospital patient records at Imperial and King Edward when we both agree it would be helpful to share specific information with other professionals.