Women’s Health Psychological Services (WHPS) is an essential dimension of ethical, holistic and quality care for women and their families. Through direct patient care, psychological education for health professionals and support for colleagues in clinical teams, we uphold the trust values of kindness, safety, teamwork and improving.
Our objectives are to:
- Increase patient capacity to cope with health conditions and treatment demands.
- Help patients to (re)engage with key life goals.
- Facilitate informed consent where treatment choice is psychologically complex.
- Provide education, supervision and support for Women’s Health and trust staff.
- Improve the quality and quantity of psychological research in women’s health.
People with difficulties conceiving have described their experience as “a roller coaster of emotions”. Treatment may be possible, but it inevitably comes with practical and emotional challenges. Many people find themselves facing dilemmatic decisions. Some say that the level of uncertainty is intolerable. Fertility problems are hard to discuss, and people who struggle to be open about their distress may experience limited support from friends and family. The situation can put a strain on relationships.
Counselling provides a safe space to explore private thoughts and feelings skilfully. The process can help people to see the situation more clearly, let go of ideas and patterns no longer useful, feel ready to re-set priorities, open up to new ways of coping, and experiment with a wider range of solutions. Patients are most welcome to self-refer as and when they are able to attend appointments. We look forward to hearing from you.
A number of genetic conditions can affect how the reproductive and sex organs are formed. The conditions used to called ‘intersex’. In medicine, they have recently become known as ‘differences’, ‘divergences’ or ‘disorders’ of sex development (DSD). Some psychologists prefer ‘diverse’ sex development (dsd). Most affected people do not identify with any of these labels.
We know that women with dsd diagnoses can live very well. We also know that at some time point, psychological input can be helpful for working towards important life goals such as a cultivating a positive self-identity, reducing stigma, accessing relationships and enjoying sex. The psychologist interfaces closely with the physician/surgeon and client, perhaps especially when complex or invasive interventions are being considered for psychological reasons (e.g. to be happier) rather than to treat an illness.
The psychologist consults alongside doctors and nurses in multi-disciplinary clinics and also meets separately with clients and families. Anyone attending the specialist team at UCH can request to meet with the psychologist.
The Zahra Clinic runs weekly to provide a service for adults affected by FGM. It consists of a gynaecologist, an obstetrician, a midwife and a clinical psychologist. The team is assisted by our dedicated clinical fellows, trainees and interns who have helped to forge and maintain close links with community groups. The psychologist’s role is to develop brief psychological interventions for women and couples adversely affected by FGM and to triage to local psychological and mental health services as appropriate. Referrals to the psychologist are via the team doctors or midwife.
The paediatric and adolescent FGM service runs once a month with a child psychotherapist as a team member. All children and young people and their families can meet with the psychotherapist after the diagnostic medical examination. The child or young person and the parents can be seen separately or together. This consultation provides a supportive space where the psychological impact of FGM and/or the experience of referral and examination can be explored sensitively. Brief therapeutic input is provided if appropriate for the service.
Two part-time clinical psychologists work closely with doctors and nurses in this subspecialty. Psychological input is focused upon 1:1 therapy to address post-cancer treatment symptoms, psychosexual problems, decisions relating to genetic cancer risks, elective oophorectomy, and support for partners and families. Referrals are usually made by the consultant or specialist nurse in gynaecological oncology at UCH.
Importantly the psychologists also provide group work for patients as well as ward teaching and reflective groups for staff. The consultant psychologist is a key member of the trust’s steering group for the monthly Schwartz Round ® and a national trainer and provider of advanced communication skills training for clinicians working in cancer and palliative care.
A psychotherapist is available at the NNU most days of the week. The aim is to get to know all the parents informally, and to provide tailored 1:1 or family-based emotional support as appropriate. Fathers who have difficulties with appointments can request to be seen early in the day and also some evenings. Anyone requiring psychological input only has to ask a staff member at the NNU.
The weekly Pudding Club is a place where parents can connect with each other. The psychotherapist also hosts a fortnightly forum for junior doctors to explore some of the psychosocial challenges of working in a neonatal unit. There is also a monthly group to facilitate nurses to process the emotional aspects of the important work that they do. Group support for fathers is currently being piloted.
The perinatal loss service offers psychological input for to women, couples, and siblings, in the event of actual or expected perinatal loss after 14 weeks gestation, including stillbirth, termination and reduction of multiple pregnancies. Although the psychological input is limited to a maximum of 6 sessions, it nevertheless provides a useful space where confusing and conflicting feelings can be explored and processed. Clients can be seen in the ward, fetal medicine unit, and/or in outpatient clinic. They may self-refer or ask a maternity staff member to make a referral.
Coming to terms with losses take time, so that support may need to extend beyond our limited service. This would be discussed with the client and where appropriate, recommendations are offered to the GP for triaging to local services.
Women respond differently to pregnancy, physically and psychologically. Some pregnant women say they have never felt better, others are less sure of how they feel. Pregnancy and motherhood may highlight problems that were less obvious before. Some women who have had psychological difficulties in the past may become more concerned about how they are feeling. They can request a referral to the Perinatal Mental Health Liaison Team. Alternatively, maternity staff or the client’s GP may make a referral.
The service manager holds an outpatient clinic every Wednesday. The perinatal psychiatrist and obstetrician hold a joint outpatient clinic also on Wednesday. The perinatal psychologist runs an outpatient clinic on Thursday. The team also consists of safeguarding staff and a liaison health visitor. We meet every Wednesday to discuss new referrals and ongoing work.
The service is embedded within our maternity unit. It is not a mental health treatment service and has no capacity to respond to emergencies or crises. The focus is on liaison and outpatient assessment, monitoring and triaging.