Clinical Psychology

'For people whose medical conditions affect their

reproductive or sexual development'

This web page has been prepared for people who have a medical condition that affects their reproductive system or sexual development and who are considering consulting a clinical psychologist. It provides the answers to some of the most commonly asked questions about clinical psychology.

Who are clinical psychologists?

Within the UK, clinical psychologists most commonly work in health centres, clinics and hospitals. They are not medical doctors and do not prescribe drugs. Instead they use their knowledge of behaviour, emotions and thinking, to assist people who are having difficulties. In the medical context, such difficulties might be to do with managing the social implications of living with a particular condition, or complex decision-making processes about some medical treatments.

To become a clinical psychologist in the UK, it is necessary to study for a general degree in psychology first. Graduates are usually required to get work experience in research or clinical settings. If on the basis of their general degree and subsequent work experience they are selected for accredited training, they will go through another three years of full-time training in clinical psychology leading to a professional doctorate. This qualifies them to practise independently in health care contexts.

Trainee clinical psychologists are usually salaried employees of a health authority. They carry out consultations under regular supervision.

How might a clinical psychologist assist you?

The clinical psychologist may simply, but importantly, provide an opportunity to talk and think about things that are unclear or worrying. They would also discuss with you different ways of understanding or interpreting your situation or managing disclosure.

Many people are already aware that psychologists work with problems such as low mood, stress, anxiety, bereavement, but fewer people are aware of the fact that psychological approaches can be applied by individuals in practical ways, e.g. to follow a programme to make some lifestyle changes, or to increase personal independence or social skills, or to overcome avoidance, and so on.

What happens when you attend a meeting with the psychologist?

You will typically meet for about 50 minutes and have the opportunity to talk about your situation and to ask questions. The psychologist may also ask about other aspects of your life so as to get a more complete picture.

At the end of the meeting, the psychologist will discuss with you whether or not further sessions are likely to be useful. If further sessions are agreed, a particular type of approach or therapy might be recommended, based on your needs and the resources available. This may take the form of one to one sessions, or work that includes your partner or family, or a place in a group for people with similar concerns.

Meetings may be weekly, fortnightly or monthly but often the intervals vary. Early on you would discuss with the psychologist roughly how long the sessions would continue, and you are of course free to end the sessions at any time if you wish.

What’s the down side?

There are no quick fixes and this can be disappointing. Furthermore, some things in life cannot be changed, and sometimes it is other people or society that need to change. But it is possible to learn to live more comfortably with yourself, and to make the most of what can be changed, with encouragement and feedback from another person who is familiar with your history and your current situation.

New ideas might make you uncomfortable at first, but in time they can lead to a greater sense of control over aspects of our lives. Learning to think about yourself or your situation differently may mean not being able to behave in the same old ways, so alternatives would have to be considered. For example you may become more uncomfortable about avoiding aspects of life and find yourself having to contemplate taking some risk to incorporate new experiences into your life.

In order to change the way you think or feel about any situation e.g. to feel more in control or to behave differently in situations, you may be asked to do some work between sessions and this requires effort from you. However any task is always agreed beforehand so you are in control of the timing and the nature of them.

Important personal changes take time, perhaps a lifetime. The reality of service provisions means that it is sometimes only possible to partially address the problems through therapy. Do share any feeling of frustration, your psychologist would be sympathetic to this.

How would you know that it was helping?

Don’t expect to feel dramatically better right away. Some people do, because being listened to and being understood can bring a huge sense of relief. If that happens, don’t be surprised when the dramatic effect does not continue. It may simply mean that you are beginning to get into the nuts and bolts of the difficulties.

However, you should expect to:

feel comfortable with the therapy situation soon;

feel that, in time, you are gaining new ideas about your life experiences, e.g. the way you think and feel about situations, or the way you act or avoid action sometimes;

begin to solve problems taking a step at a time;

feel more in control of aspects of your life.

If you don’t feel as if you are getting much out of your sessions, try and talk it over with your psychologist and if things don’t change, perhaps the timing is not right or perhaps someone else is better equipped to assist you.

What about confidentiality?

The information that you provide is confidential. However a clinical psychologist would routinely write to the referrer (usually a doctor from the clinic) to summarise the outcome of the referral. If you have queries about confidentiality do discuss this with the psychologist. Your psychologist would take action only if there were a serious risk of harm either to yourself or other people. If this were the case you would, if at all possible, be notified that confidentiality was to be broken.

What if you require more general or enduring psychological support?

If you have general difficulties that require more sustained input from a generic mental health practitioner, you could try and access help through your GP, your specialist may want to provide a summary for your GP to aid referral processes. There are tremendous local variations in service availability. Some GPs have a counsellor or psychologist attached to the practice, though again therapy tends to be available for a short time only. Some GPs refer to the local community team (CMHT). Your local CMHT is probably made up of psychiatrists, community nurses, social workers, occupational therapists, clinical psychologists and others.

If you are considering private therapy such as psychoanalytic therapy which tends to be for the longer term, be sure to see an accredited and experienced practitioner - don’t forget that you are entitled to ask the practitioner for their credentials. Much of the information relating to what you can expect should also apply to therapists other than clinical psychologists.

Practitioners who are not familiar with your particular medical condition can still offer valuable help. You can always send in some information about your condition first. If you are considering a referral to another practitioner, remember that there is a waiting time, so don’t leave it to the last minute to get referred.

Dr. Lih-Mei Liao MSc PhD AFBPsS

Consultant Clinical Psychologist

& Honorary Senior Lecturer

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This Page was updated 30-Apr-2006

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