Clinical Psychology in the York Diabetes Service

At the York Diabetes Service we have a Clinical Psychologist, Dr Jess Brown, as part of the team. People are often surprised to find a psychologist in a physical healthcare service, and this page aims to explain a little about her role.

Why have a psychologist in the team?

Adjusting to a diagnosis of diabetes, or having lived with diabetes for a long time can be very difficult. Other pressure in life can also impact on how you cope with diabetes and vice versa; living with diabetes can make those other pressures harder to manage.

When things do feel difficult, many people find that talking over their problems with someone is helpful.  This might be a friend or relative, or might be one of the diabetes team who you feel you can talk to.  This is often enough, but there may be times when, even with that support, things still feel overwhelming. You may like to discuss something in private, separately to people that you care about or are looking after, or you may want to consider some therapy. A clinical psychologist can help at these times.

What is a clinical psychologist?

Clinical psychologists are trained to work with people to reduce psychological distress. They can use different types of talking therapy depending on what suits you and what your goals are.  They do not use medication.

What sort of difficulties can clinical psychologists help with?

Here are examples of difficulties a diabetes service clinical psychologist may be able to help with, and there may be others not on this list;

• Feeling depressed, angry or worried about diabetes or its’ treatment
• Sleep difficulties
• Anxiety, including fears about aspects of treatment, hypoglycaemia or hyperglycaemia
• Self-esteem or body image issues related to diabetes
• Difficult decisions about treatment
• Issues around conception and pregnancy that are linked to diabetes
• Problems in following treatment recommendations
• Moving from paediatric to adult services
• Problems resulting from diabetes impacting on family or other relationships

What is involved?

Initially, you would be offered an assessment. At the start, this involves talking through the difficulties you are experiencing so that the psychologist can understand what you are struggling with, what you’ve tried before and what your goals are for psychological sessions.  They may sometimes use questionnaires to help their understanding, and, if you agree, they may talk to other important people in your life. This gives them the chance to think about what psychological approach might be the best ‘fit’ for you.

Considering talking to someone in this way can feel daunting, so it might help to remember that part of the training that psychologists have is in putting people at ease and helping to make this conversation as manageable as possible.

After this, you’ll make a plan with the psychologist. Sometimes things feel better after that appointment, and no further sessions are needed. Equally, you might decide that psychology is not for you and that you don’t what further appointments.

If you do want further appointments, the plan could be to work jointly to your goals using psychological approaches, or it could be a referral to another service if they can better meet your needs.

The number of sessions that are needed does vary and this is reviewed as you go along, to see whether it is helping you in the way that you want. To meet service needs, sessions are contracted at the beginning depending on the issue and your goals. We are not able to offer long term therapy from the diabetes service.

Confidentiality

Information discussed in psychology sessions is confidential and only shared with other members of the team if you agree to this, or if essential to your treatment or safety.  Information will not be given to others such as family members, unless this is what you would like.

How can I be referred to see the clinical psychologist?

Any member of your diabetes team can make a referral on your behalf. Jess and the team are always happy to discuss any questions you have. At the moment we’re not able to take self-referrals.

If you need help urgently

The York diabetes psychology service is not a crisis service. If you feel you are in crisis, or a risk to yourself or others please contact your GP or local crisis service: York (0800 0516 171), East Riding (0800 138 0990).

Psychological work is your choice

If a member of the team suggests a referral to psychology and you don’t want to take it up, that won’t affect the care that you receive from the rest of the MDT.