Secondary care psychology service

Secondary Care Psychology 

From the 1st October 2024, a Secondary Care Psychology Service has been created that sits separately from the Borders Adult Community Mental Health Service (BACMHS). The Secondary Care Psychology Service is for patients who have moderate to severe mental health problems who are seeking psychological therapy. It offers both group and individual therapy, we usually encourage patients to attend a group in the first instance where this is likely to meet their needs. 

It is important to emphasise that Secondary Care Psychology is not a part of the BACMHS and that GPs will retain medical responsibility for patients seen under Secondary Care Psychology. 

For patients who require multidisciplinary support, for example assessment and diagnosis of mental health problems or advice on medication, then referrals should be made to BACMHS. There will continue to be psychology provision within the BACMHS which is part of the multidisciplinary treatment team. The psychology provided within BACMHS is called CMHT psychology to distinguish it from Secondary Care Psychology. 

For patients with mild to moderate mental health problems then consider referring to Renew – Primary Care Psychology Service. 

The secondary care psychology service sees adults who are ages 18 to 69. 

Psychological therapy offered in Secondary Care Psychology Services is time limited and is typically 8 to 16 sessions. There is no multidisciplinary team in this service and so patients need to be able to tolerate the potential for a wait of a number of weeks duration between having an assessment and treatment starting. They also need to be able to tolerate the distress that can arise within sessions without a significant increase in risky behaviours. 

Psychological treatment may assist in the reduction of risky behaviours. However, a prolonged requirement to focus on risk and care planning can detract from the core focus of psychological therapy. It is therefore important that people who are referred for psychological therapy are safe, stable enough and ready to engage in psychological treatment. 

The key criteria that psychologists will use when considering referrals to psychological services are as follows: 

• Age 
• Risk 
• Impact of functioning 
• Goals for treatment 
• Levels of distress 
• Psychological mindedness 
• Readiness for change 
• Presence of co-morbid physical or neurological problems 
• Significant problems with substance misuse 
• Recent period of psychological intervention 
• Substantial previous input from psychology 

These criteria are described in more detail in our referral criteria guidelines. 

What do we provide? 

We provide psychological assessments of a person’s mental health problems which will include a psychological formulation. An assessment may be followed by receiving psychological therapy. The type of therapy received will depend on what a person needs and the outcome from an assessment with a psychologist in our service. We provide evidence based psychological therapy in both individual and group formats.  

The types of therapy that might be received will include Cognitive Behaviour Therapy (CBT), Compassion Focused Therapy (CFT), Dialectical Behaviour Therapy (DBT), Acceptance and Commitment Therapy (ACT), trauma focused CBT and Eye Movement Desensitisation and Reprocessing (EMDR).