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). 

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.

At our initial consultation, which we can as a face-face appointment or via video clinic, I will listen carefully to establish your concerns, clarify your current cancer treatment plan and discuss your experience of it, understand your broader psychological and social situation, and evaluate specific psychological strengths and vulnerabilities that are relevant to coping with your specific cancer and treatment situation.

You will be also able to get a good sense of our rapport and whether you feel this is a safe, respectful space to talk, reflect and learn.

The initial consultation is often sufficient to provide a safe outlet to talk freely about the experience, get practical advice and signposting to releveant self-care.

We will also agree a fully personalized plan, which can include:

• guiding you to developing psychological strategies or tools for general wellbeing or a specific purpose e.g. preparing for a particular treatment

• sessions focused on broader psychological challenges - e.g. anxiety in relation to long-term outcomes, making difficult decisions, disclosing cancer to children, family and workplace, caring for a partner who is struggling, building confidence about returning to work, coping with being in hospital, coping with impact of treatments (e.g. hormones), adjusting to body image and sexual function changes after surgery, anticipating dying, etc. 

• open access to sessions on-request, to process the experience as it unfolds, - which is usually a component of all plans

• referrals to other specialists, e.g. psychiatric, neuropsychological or psychosexual input

It's worth adding - if we plan for further input, there is no expectation that patients need to follow a particular, pre-defined course of psychological therapy. Typically, to address cancer challenges as they arise, we will draw on a variety of psychological models (e.g. ACT, CBT, BSFT, CAT etc) that best fit your particular strengths, preferences and situation. 

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 they key points and 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.