Psychology

Clinical Psychologists are trained to help people understand and deal with difficult emotions, thoughts and behaviours. They talk with people about issues that are important to them. They try to help them find a way to move forward. Clinical Psychologists are not medically trained; they do not prescribe medication and do not conduct physical examinations. Clinical Psychologists can help with a wide range of problems that affect quality of life or make it difficult to have medical treatments or procedures. The person you see will have an understanding of the psychological effects that cancer and treatment for cancer can have. Clinical Psychologists are regulated by law and registered with the Health and Care Professions Council (HCPC).

Clinical Psychology is fully embedded into the team and Claire, Kathleen and Caroline are available Monday – Friday for inpatient and outpatient appointments.

Pre-Transplant

• Psychological assessment is part of the standard pathway for all patients undergoing allogeneic and CAR-T transplants, and people having these treatments are seen during the pre-transplant stage. We try to meet with you at a pre-transplant clinic or, if that is not possible, we will meet with you online using Attend Anywhere video call. We can meet you alone, or you can choose to have your partner, a family member or a friend with you. At this appointment you will have a chance to discuss any worries or concerns you may have; coping strategies that might help during transplant and recovery; and how the psychology team might offer you further support if this is needed.

During transplant

• Sometimes we will agree to see you on the ward because you have told us you have worries about some aspect of your admission and we have agreed it will be helpful for you to have psychology support as part of your overall care plan. Sometimes people decide they need support after they have come in, or staff might suggest it. Either way, whatever kind of transplant you are getting, we can support as needed during the admission.

Post-transplant

• Recovery from transplant can take a long time. Some people find they need extra support to process all they have been through or to start building up their life again. This might be straight after discharge or even months later.

Everyone experiences some level of worry, distress and a whole range of other emotions as they go through transplant. However, if these feelings start to feel overwhelming, or if they are interfering with your ability to have treatment, or to get on with life, this could be a sign that it might be helpful to speak with someone.

Talk to your CNS or haematologist if you think you need extra support for emotional recovery.

Depending on what type of transplant you are receiving then we might see you and then link back in with services available in your local area.

Your psychology appointment is a safe and confidential space for you to share your concerns or any difficulties that you have in relation to your treatment/transplant. If you are seen as an out-patient, the appointment usually lasts around 45-60 minutes and can be via video call, face-to-face in the outpatient clinic, or on the ward. The number of sessions that everyone needs is different, so your psychologist will agree this with you.

Being seen as an in-patient: this is much the same, except you will be seen in your room and the appointment time might be less, depending on how well you are feeling that day.

Sharing information / consent

• We will keep a written record of discussions within your electronic medical records which other members of your care team can access. We do not always need to document everything that is talked about. 
• If there is something that you would prefer not to be documented, please discuss this with your psychologist. We are able to keep information confidential, unless we have a concern about your safety or someone else’s safety – in those circumstance we may have to share information to keep you or others safe.
• Sometimes a letter is also written to your GP, hospital consultant and other appropriate members of your care team. If you have any concerns about what information is shared and who can access it, please discuss this with your psychologist.

Having a transplant can be hard and you are likely to have lots of different feelings, especially in the run-up to your admission. Finding a way to talk about your worries will help prepare you for transplant. If you find it hard to talk about, writing things down can also be a useful way to gather your thoughts and help mentally prepare yourself.

• Remember it is normal to feel anxious or worried in the run-up to transplant.
• You can feel worried or scared and hopeful and optimistic at the same time.
• Learning to notice and name your feelings can help you manage them.

Lots of things might feel out of your control. Find a way to let go of the things you cannot control, for example, tell yourself you give the medical team(s) permission to manage all those things. Allow yourself to focus on the things you can control, for example, your day-to-day routine. When you are in hospital, this tends to be about when you get up; having a wash; exercising; eating and drinking; or keeping in touch with loved ones and supporters.

Before you come into hospital, think about what you want to bring in to make your room a nice space to be, or to help keep yourself occupied. For example, you might want to bring in photographs, pictures, cushions or a blanket. You might want to think about arts, crafts, puzzles, or download audio books, podcasts or movies in advance.

It can be helpful to think in advance about how you will keep in touch with people. Sometimes having a WhatsApp group is a good way to stay in touch with a group of friends or family members. Let people know you might feel tired and won’t always be able to reply, but that you would still like to get messages or texts from them.

When the person coming for transplant has a cancer diagnosis, we know this can have an impact on wider family members, including people who are supporting you and also any children in the family.

We are able to offer brief support for family member/carers for difficulties relating to how they are coping with the current situation. If this is something that you think would be helpful, please speak to a member of the BMT team who will be able to make a referral to us. There are also helpful services through other organisations: 

• Macmillan Cancer Support - Emotional support for family and friends 
• Maggie's - Friends and family

We often help families think about how to support children.  We would encourage you to make sure their school/college are aware, so they can access relevant support through existing services. We have included some links to other helpful resources below:

• Anthony Nolan - Lucy and the Good Soldiers 
• Fruitfly Collective
• Winston's Wish 
• Child Bereavement UK

During the last patient audit, carried out in 2021, 100% of those people who saw psychology were ‘very satisfied’ (84%) or ‘satisfied’ (16%).

“I wish to thank you for what you have done for me…your dedication and kindness. I have taken some comfort and important decisions along the journey!”

“I just wanted to thank you for all you did for us during … time in hospital. It helped me enormously just to have someone to listen to my moans and I know … appreciated the time spent talking to you… and how much it helped”.

"I would just like to take a minute to thank you for all the help you have given to me. It certainly has seen me through the darkest of days”.

We are not an emergency service so if you are currently in crisis and feel unable to keep yourself safe, please contact your GP immediately or use some of the services below:

• NHS 24 on 111
• Samaritans on 116 123
• Breathing Space on 0800 83 85 87

If you are currently an inpatient, please speak to one of the team to get support.

Mindfulness

• NHSGGC - Walking in the Rain (video)
• NHSGGC - Balloon Breathing (video)
• NHSGGC - Safe Place Visualisation (video)
• Maggie's - Relaxation and breathing exercises (webpage)
• Therapist Aid - Grounding Techniques (worksheet) 
• NHS24 - Steps for Stress (audio)

Apps

MyApp: My Mental Health. This App has been developed by NHS Greater Glasgow and Clyde and has lots of useful information. Follow these steps to find this:

• Download the App from your App Store.
• Press the ‘more’ button, then ‘Change user mode’ and select Public/Patient.
• Press the ‘Home’ button and in the search box type My App: My Mental Health Toolkit’ and then ‘Add to my Toolkits’.

Other apps:

• Sleepio 
• Breathing Zone
• Headspace (you can pay for some services in this App, but the free version offers good resources).

Podcasts

• A podcast is like a radio show or programme that you can listen to anytime you like. Most phones have a podcast app. You can also find podcasts on Apps like BBC Sounds, Spotify or TuneIn. You can search for a podcast by show title, host, or by topic. Once you find something you like, you can download the show or you can subscribe to a show which means you always get new episodes. Most podcasts are free to listen and download; subscribing does not mean you are signing up to pay, it just makes sure you get the new episodes. You can listen to podcasts anywhere if you have wifi or data, but downloading a podcast means you can listen to it anytime without relying on wifi or data which can be handy for the hospital.
• If you have a smart speaker like an Alexa enabled device or Google Home, you can ask those devices to play a podcast for you. Of course, you need to know the name of the show you are calling up, but if there is a show you have heard of and you own one of these devices, try asking for the show to be played.

Activities that can help pass time during your admission

• You can bring in things that might help you pass time during your admission like colouring books, crafts (knitting or stitching), magazines, puzzles or video games. Most people find their concentration is poor and as, a result, find it hard to concentrate on books when they are in for a transplant. You might find it easier to read or look at magazines or papers. Or you might want to try audio books to listen to.
• You will have a TV and radio in your room, but many people like to download their favourite shows or films and have these on a tablet or laptop to watch.
• Play lists of your favourite music can be helpful to make up before you come in.

Online activities that might help pass the time during your admission

Art & Galleries:

• Many museums and galleries from all around the world can be found in the Google Art project. Search in your browser for ‘google art project’ or type this address in: https://artsandculture.google.com/
• Some museums have full virtual tours, such as this one in London which allows you to zoom in and see artwork up close: https://courtauld.ac.uk/gallery/about/3d-gallery-virtual-tour
• Look here for other suggestions: https://www.travelandleisure.com/attractions/museums-galleries/museums-with-virtual-tours

Nature and wildlife:

• It can be hard being in hospital with little to look at and no contact with nature. Looking at scenes of the outdoors, of animals and nature or even of sea life can be soothing. It helps take you away from the hospital and can be a pleasant distraction, even reducing anxiety.
• One of the best sites is explore.org. Type this into your search engine and once on the site, look around using the tabs at the top. You can find videos and livecams of fish in aquariums; waves & beach scenes; plus animals and birds from all around the world. You can watch any of these with or without sound.