The Clinical Psychology and Psychological Therapies Department aims to provide accessible, effective and efficient psychological services to the local population, on a Trust-wide basis, with the aim of promoting psychological health and well-being.
The Clinical Psychology and Psychological Therapies Department provides services across a range of specialisms, as listed below.
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Adult Autism Service
The Adult Autism Service is managed through the Clinical Psychology department. This multidisciplinary team comprises of staff from Psychology and Occupational Therapy backgrounds. The service offers diagnostic assessment and intervention for adults with a diagnosis of autism. The service also provides staff training, support to carers and participates in research activity.
For further information please contact: the Consultant Clinical Psychologist on Tel: (028) 9250 1326
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Adult Psychological Therapies Services
We offer a Psychological Therapy service (both individual and group therapy) for adults aged 18-65. The service is mainly outpatient based but also in-reaches to the Trust Mental Health Inpatient Units when requested.
We see a wide range of acute and chronic problems including Panic Attacks, Agoraphobia, Depression, Generalised Anxiety (excessive worry), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Sexual Abuse, Self-Esteem, Occupational Stress, Sexual Problems, Anorexia, Bulimia, Binge-Eating, Personality Difficulties, Emotional Instability, Trichotillomania, those with a diagnosis of Schizophrenia and Bipolar Disorder, Body Dysmorphia, Health Anxiety and Social Anxiety.
We accept referrals from 2 sources only:
- From Mental Health Assessment Centres (GP referral).
- From Professionals within Mental Health Services already working with the patient/client.
If you would like to be referred to our service please speak to your GP or Mental Health Professional.
If you have any queries regarding our service you can contact us on Tel: (028) 44 513 880
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Children’s Paediatric Clincal Psychology Services
The Clinical Psychology Paediatric Service offers a specialist quality community based clinical psychology service to children up to the age of 18 years with emotional, behavioural, social and psychological difficulties related to medical and chronic health conditions.
Services provided include individual based psychological assessment and neuropsychological assessments and a range of individual and group therapeutic interventions for children/young people and families. The service also provides consultation, supervision, support and reflective practice as well as training; service development and research, service evaluations and audit.
Referrals will be accepted through the Child Health single point of entry from a specific range of healthcare professionals involved in caring for children and young people.
RISE NI (Regional Integrated Support for Education) is a multidisciplinary team that supports children in school by working closely with parents and school staff to help children develop foundation skills for learning. Children from P1 – P4 can be referred to this service by teachers (with parental consent).
If you have any queries about Clinical Psychology Paediatric Services you can contact the Consultant Clinical Psychologist on Tel: (028) 92635771 or (028) 9151 0190
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SET Scaffold Consultation and Therapeutic Service for Care Experienced
Children and Young People
This Consultant Clinical Psychologist led service is comprised of a Principal Social Worker Service Manager, Clinical Psychologists, Therapeutic Social Work Practitioners, an Advanced Practitioner (AP) Speech and Language Therapist and AP Occupational Therapist. The five Scaffold teams across the region are specialist consultation and therapeutic services for children and young people with lived experience of care, and the networks that surround them.
We accept referrals from Field Social Workers for young people up to the age of 18 years where there are concerns about social, emotional and/or behavioural difficulties which are placing a significant strain on the family or placement; and early childhood history of trauma and attachment difficulties is impacting upon current emotional and relational functioning. All children and young people living within the seven mainstream residential homes of the SET receive a therapeutic care plan formulated and delivered in conjunction with their Residential and Field Social Workers and wider caregiving network.
Referrals are made using the online referral form on the South Eastern HSC Trust intranet.
If you have any queries about this service you can contact the team at Hilden Resource Centre, Lisburn on Tel: (028) 9266 7990
ACORN Therapeutic Service: NI Secure Care
Providing Acceptance, Connection, Opportunities and Relationships to meet individual Needs
This service comprises of Clinical Psychology, Psychiatry, Mental Health Practitioners, Social Worker and Occupational Therapy. We provide equivalent to Step 3 Child and Adolescent Mental Health Service (CAMHS) clinical care and enhanced therapeutic input to young persons admitted to either of the two regional secure care facilities; Lakewood Regional Secure Care Centre and Woodlands JJC.
We offer supports and input to all children and young people admitted to NI Secure Care in line with identified needs and also the wider care giving network around them.
If you have any queries about this service you can contact the team at Lakewood Regional Secure Care Centre, Bangor on Tel: (028) 91515473
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Clinical Health Psychology Service
The aim of this service is to offer psychological support to people who are experiencing emotional distress resulting from their physical health condition and its associated treatment/management. Services are offered to diabetes, ICU, chronic pain, oncology and plastic surgery patients who are aged 18 years or over.
Services may be provided individually or in a group based format and include psychological assessment, individually tailored psychological therapies, consultation to health professionals and third sector organisations, training, and clinical supervision of staff offering psychosocial/psychological care.
Referrals for diabetes, ICU, plastic surgery and chronic pain patients can be made by the person’s Consultant or a member of their hospital team only.
Referrals to the service for patients with cancer can be made by the person’s Consultant, GP or any member of their health care team. Referrals can only be made for patients who are within 2 years of their cancer diagnosis or recurrence of cancer and who are being treated in the South Eastern Trust.
If you have any queries about these services please contact:
- Chronic Pain:(028) 9056 1340
- Plastic Surgery:(028) 9055 3278
- Diabetes & ICU:(028) 9055 3225
- Cancer Services:(028) 9056 4810
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Clinical Psychology Learning Disability Service
This service offers assessments and interventions to children/young people (up to the age of 18 years) and their families for a range of difficulties including challenging behaviour, mental health difficulties, relationship difficulties, trauma, bereavement/loss and assessment of Learning Disability (LD). We also provide some support and consultation to staff teams who work with children who have a LD.
Referrals are accepted from GP’s, Psychiatry service for children with LD, Children’s Disability Teams, Education staff and Trust staff who work with children who have a LD. For children and young people who are referred to the service who have not already been identified as having a LD, assessment will be carried out to establish if they meet criteria for a diagnosis of LD before any psychological assessments and/or therapy will be undertaken.
If you have any queries about the service, please contact the service directly on (028) 9263 3328.
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Clinical Psychology Service for Older People
The Clinical Psychology Service for Older People (CPOP) is provided within the context of the multidisciplinary Mental Health Service to Older People (MHSOP) team. The service is led by a Consultant Clinical Psychologist, with two part-time Specialist Clinical Psychologists.
Location of the Service
We offer out-patient services in three locations across the Trust, namely Lisburn (at Lagan Valley Hospital), Downpatrick (at the Downe Hospital and the Downshire Estate) and Newtownards (at McQueen Home, Ards Community Hospital). We also see in-patients at Lagan Valley Hospital, the Downe Hospital and the Ulster Hospital. We can see clients in their own homes for initial assessment (by exception) with view to ongoing work at clinic.
Target Groups/Age Limits
We see individual clients who are aged 65 years and over, with or without a carer, as they prefer. Clients under 65 are considered when their needs are assessed as best met by an older people’s service (eg. Early onset memory difficulty / queried dementia). Our clients are referred by Psychiatrists working in the Mental Health Service for Older People. We also run groups targeting specific difficulties based on need (eg. Grief, Carer Stress).
Presentations / Interventions
Psychological Therapies
We offer evidence based psychotherapeutic input to individual clients presenting with the full range of mental health problems but most commonly; anxiety, depression, post traumatic stress disorder, complex PTSD, complex personality issues, and adjustment difficulties. Given the complexity of cases, approaches are tailored to individual clients based on a comprehensive assessment and psychological formulation of difficulties. Psychological approaches integrate Cognitive Therapies such as Cognitive Behavioural Therapy, Schema Therapy, Acceptance and Commitment Therapy, Compassion Focused Therapy, Dialectical Behaviour Therapy, and Eye Movement and Desensitisation Reprocessing (EMDR).
Formulation / Strategy Meetings
Clients will often be concurrently receiving care from other members of the multi-disciplinary team, most notably Psychiatrists and Community Psychiatric Nurses and we try to maintain good channels of communication. We offer psychological formulation sessions / reflective practice sessions for ward and community teams for complex and challenging cases.
Neuropsychological Assessments / Behavioural Support
We also offer a neuropsychological assessment service to aid in the differential diagnosis of dementia in complex cases. This involves the testing of memory and other cognitive functions as well as a comprehensive clinical assessment. Clients who are referred to this service are seen alone or with a partner/carer as they wish and the carer is involved in the assessment process from the history taking until the feedback stage with the client’s consent. As an adjunct to this service we provide advice in behavioural management for formal and informal carers.
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Neurodisability Services
Clinical Psychology services are provided within the following Neurodisability services:
Community Acquired Brain Injury Rehabilitation Team
This team consists of a range of healthcare professionals. Its main aim is to maximise independent functioning, psychological wellbeing and social functioning.
Referrals are accepted from any healthcare professional within any care setting for individuals over the age of 18 years.
Thompson House Hospital, Lisburn
Thompson House Hospital is a specialist unit in Lisburn which provides nursing care and support services to individuals over the age of 18 with complex neurological illness and acquired brain injury. Inpatient services include respite, assessment and rehabilitation. Services are provided through a multidisciplinary approach and aims to maximise functional ability and independence of patients, with the overall goal of returning to live in the community. Referrals to Thompson House Hospital can be made by any professional involved with the individual and all referrals will be considered by the multidisciplinary team who will determine if the individual is suitable for the service.
Community Stroke Team
The Community Stroke Teams are specialised, multidisciplinary teams that provide rehabilitation following stroke. The Team provides in reach into the Downe hospital, early supported discharge to appropriate patients on discharge from acute hospitals (intensive rehabilitation based on clinical reasoning and patient choice), and needs-led rehabilitation within the home environment. The service aims to maximise each individual’s functional ability and independence, and to facilitate re-integration in the community.
For further information about Clinical Psychology Neurodisability Services please contact the Consultant Clinical Neuropsychologist on Tel: (028) 9151 1192
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Psychological Therapies Team in Healthcare in Prison (HiP)
We have a small, dedicated team delivering Psychological Therapies across the three Prison settings regionally, HMP Maghaberry, HMP Magilligan and HMP Hydebank Wood College (incorporating Ash House female prison) within Healthcare in Prison (HiP).
HiP is an Integrated Primary Care model delivered by a highly motivated multidisciplinary team of healthcare professionals who want to make a difference, improve the health outcomes for all people in prison and make Northern Ireland a safer place. Improving and bettering the mental health, physical health and substance misuse needs of people in secure environments has the potential to improve their quality of life while inside and have a lasting impact on their health beyond release. This will have a further positive impact on the wider community. The team aims to provide opportunities for people to develop a positive attitude towards their health and well-being on an individual basis or through public health initiatives. The service is focused on providing care that is at least equivalent and consistent to that available within community GP led health centres and includes input from in-reach services. HiP staff work collaboratively with our partners including Northern Ireland Prison Service, and voluntary organisations to meet the needs of people in our care.
HiP Mental Health Team is based on a stepped care mental health model to ensure people with common mental health disorders are helped to choose the most effective interventions and those requiring treatment that is more intensive may be referred on for Psychological Therapies. The Psychological Therapies Team provided individual based psychological assessment and neuropsychological assessments; a range of individual and group therapeutic interventions, consultation, supervision, support and reflective practice and training.
- Accessibility Guides
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Coping after a frightening and distressing event
Supporting children and young people following a frightening and distressing event.
During a frightening and distressing event, the brain and nervous system automatically take charge of our survival through the fight, flight and freeze response. This focussed view of what is happening at the time helps the brain to make quick decisions. After the event is over and this threat-focussed response is no longer required, we can gradually connect again with the world around us, enabling us to realise the danger has passed.
Children and young people may initially appear very upset, quiet, or agitated. It can take a few hours to several weeks after the event has ended for children and young people to feel safe again – this is normal and it is best not to compare one person’s reaction and recovery to another. The majority of children and young people will recover from the event within this timeframe, meaning that their threat-response system has re-set and they have been able to understand the event and their reactions to it in a way that makes sense.
What helps? Feeling safe with a trusted person in a familiar environment will help the young person recognise they are no longer in immediate danger. The presence of calm and understanding carers, who can comfort young people and offer a safe space for listening if the young person wants to talk, helps the natural recovery process. Maintaining routines, or adapting these flexibly in the short term, helps maintain a sense of predictability to young people.
Physical comfort – Where appropriate, from a trusted adult and when wanted by the young person. Could include hugging, holding hands, gentle rocking, or rhythmic movements like tapping or stroking. Comfort from familiar textures and sensations such as comfy clothing, stuffed toys, pets, and their favourite foods or drinks. Young people may be frightened to be left alone initially and so being physically near a calm caregiver can help them feel protected and safe. Warm, friendly facial expressions, gentle eye contact, open body language and soothing tone of voice also help to regulate the young person’s nervous system.
Making sense of reactions Caregivers can feel prepared that it is normal for young people to experience a range of reactions following a distressing event. This knowledge can be used to help support young people and help them make sense of their reactions in a caring way.
Reactions during the event. It can be helpful for young people to know that their responses during the frightening event were automatic rather than something they chose to do, and that there is no ‘right way’ to respond. Older children and young people may be aware of the fight/flight/freeze response as the brain and body automatically reacting to keep us safe from danger – “a frightening event caused your brain’s safety-system to switch on and protect you as best as possible”. This can be helpful if young people are worried that they acted differently to how they usually behave.
Reactions following the event. The young person might notice different feelings and sensations. It is important to think of these reactions as normal reactions to frightening events. There are three common types of reactions;
arousal – being jumpy and easily startled, feeling intense emotions like anger, sadness or fear, being more clingy and requiring reassurance, disrupted sleep and scary dreams, feeling irritable, faster breathing and heart rate, difficulties relaxing and concentrating,
intrusive reminders – having unwanted memories or images that pop into their minds, replaying what happened and wanting to know why it happened, being suddenly pulled back into thoughts and memories like they are back in the accident again, noticing that different senses (sounds, smells, tastes, sights) can make them feel like the event is happening again,
avoidance – wanting to stay away from things that remind them of the event (places, images on TV, phrases) that may bring back memories of the event again
Young people may not experience any of these reactions, or experience several in the first few days, which then reduce over the following weeks. Knowing that these reactions can feel unusual but usually pass can help young people feel understood and able to cope.
Sharing what happened – It is helpful for caregivers to follow the child or young person’s lead, so if the young person is keen to talk about the event then reassure them you are there to listen. This may be shortly after the event or may take some time before they want to say things aloud. It is also OK if young people do not want to talk about the event and they should not feel under pressure to do so.
Younger children may “show’ details through drawings or their play. Information may be jumbled or have gaps, or be different to what was reported elsewhere. Their recall of what happened may sound different if they repeat it as they connect with different or new parts. Young people may share some details with parents but prefer to talk to others connected with the event in more detail such as school staff and friends. Young people are likely to find details via social media and want to connect with friends this way; it can be helpful to suggest they take a break from this if it is appearing too overwhelming.
As caregivers, it can be tempting to want to find out lots of detail from the young person about what happened, but try to allow plenty of time for the young person to feel safe and in control. Until the part of the brain responsible for reacting to danger is helped to soothe, it will be extremely difficult to start saying aloud what happened, especially when young people may only know part of what happened or be confused about the details. They may also worry about wanting to give the ‘right’ account in case they are worried someone may be to blame.
If the young person wants to know more and asks questions –Keep communication short and simple and leave gaps so the young person can digest the information. It’s OK to say we don’t know if we can’t answer a question, but acknowledge it’s an important question and someone else might be able to help if appropriate.
Routines and structure. Aim to keep familiar routines and support the young person to engage with these. There may be need to be some flexibility in the immediate days after the event, but returning to usual routines helps the young person experience a sense of predictability and control again.
Parent/carer wellbeing self-care. Understandably, parents and carers can also experience different reactions to the event and their young person’s recovery. Every individual is different but a range of actions such as talking with family and friends, eating and sleeping well, gentle exercise, breathing techniques, music and relaxation may be helpful. The grounding techniques below can be helpful for parents/carers and young people may benefit from trying these too.
Grounding techniques to manage strong emotions Grounding – techniques to manage strong emotions – YouTube
The 54321 grounding method The 5-4-3-2-1 Method: A Grounding Exercise to Manage Anxiety – YouTube
4-6 weeks after the event. Many young people will no longer experience the reactions listed above and will be continuing with their lives. However, some children and young people may have difficulties that persist, this may be where their usual coping strategies seem not to be helping, they are continuing to experience intense emotional feelings, and they are finding it harder to move on from the event. Discussing this with your GP at that time can help to identify if additional specialist help may be required in addition to their existing support network.
Distressing event(s) can be considered in terms of the ‘3 Es’: Event, Experience & Effects.
- The Event may be a one-off occurrence, or a series of events.
- The Event causes an Experience of harm, which may, for example, be physical or emotional.
- And this has an Effect on daily life afterwards.
When we feel very distressed, our brain works differently to how it works normally. This is because our brain is trying to protect us from the threat we are experiencing.
The fear centre of our brain is the first to develop and is located in the middle of the brain. When a threatening Event occurs, our Amygdala, whose job it is to detect danger, triggers the body’s stress response, or the ‘fight or flight’ response.
The ‘Fight or Flight’ Response or Hypothalamus-Pituitary-Adrenal Axis (HPA) Response
The Amygdala send a chemical messenger to the Hypothalamus. The Hypothalamus’s job is to activate the Pituitary Gland. So it send a chemical message to the Pituitary. Although the Pituitary is very small (about the size of a pea), it has a very important role. It releases a range of hormones which travel from the brain to the Adrenal Glands. The Adrenal Glands, of which there are two, are about the size of a walnut and sit like little hats on top of each kidney.
When the adrenal glands detect the hormones in the bloodstream, they release Adrenaline and Cortisol.
Adrenaline and Cortisol elevate the heart rate, increase your blood pressure and give us energy.
Quick, shallow breathing occurs as the lungs attempt to increase oxygen in the blood stream, you may feel dizzy or lightheaded.
Blood pressure increases as major vessels dilate, muscles become more intense ready of action and trembling can occur.
The eye pupils dilate and chills or sweats can follow as the blood vessels in the skin constrict, sometimes the palms become sweaty.
Saliva flow in the mouth decreases, the output of digestive enzymes in the stomach decreases and the bladder can often relax.
Effects after the distressing event
It can be difficult to switch off the ‘fight-or-flight’ response after a distressing event. We may replay the event in our minds, reflect on its awfulness and perhaps even conjure up images in our mind’s eye of terrible things that did not happen but could have happened. There may be injuries or other consequences of the event which cause stress and worry even after the event itself is long over.
Importantly, it’s not your fault if you are feeling this way. Your brain was in survival mode during the event and it may take some time for this to subside.
What can I do to cope?
- Allow yourself time to recover. This means avoiding taking on any new responsibilities which aren’t absolutely necessary. If you’ve been bereaved due to the event, you will need time to grieve. Try to avoid putting pressure on yourself to recover promptly. This will only add to your stress response. Your body and mind will recover in time.
- Seek support from others. Talking about the event is known to help us process what happened. This is particularly the case if you talk to someone who is discreet, trustworthy, empathic and emotionally supportive. It can be especially helpful to discuss what happened with someone else who experienced the same event. This can help you to feel understood and may help you to address some unanswered questions about the event. However, this can be unhelpful if you are likely to compare your own recovery to the other person’s recovery journey. People respond to distressing events in different ways, therefore their recovery trajectories will differ also.
- Seek practical and emotional support
Some of your friends and family may be more adept at practical support and others emotional support. Remember you may need both types of support and you should seek it whenever it is needed. There is no shame in asking for help and friends and family will want to support you.
- Keep active and maintain healthy routines
When a distressing event has occurred, it is very easy to retreat from life and relinquish our healthy routines. Try to keep active, connect with nature, eat well and maintain healthy routines around sleep. Try to limit caffeine as it activates the HPA axis.
- Look after yourself
When struggling to cope after a distressing event, you may feel distracted. This can increase the potential for accidents. Accident are also more likely if you use alcohol or drugs in order to cope with your feelings. You may need help to adopt more healthy coping patterns and resist unhealthy ones.
- Avoid focusing too much on media coverage
Understandably, you may find yourself reading media about the event or watching news items about it. However, if this causes you distress, it may be helpful to limit your intake of this content for the time being.
Please see the attached Videos Guide for helpful resources.
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Video Resources
Eat Well for Good Mental Health: https://www.youtube.com/watch?v=dH0yx3PDYQg
Sleep: https://www.youtube.com/watch?v=qmvxBEB8TCY
Caffeine: https://www.youtube.com/watch?v=b-eHJMP08hU
Structure & Routine: https://www.youtube.com/watch?v=fruZI-SjX-g
Playlist: https://www.youtube.com/playlist?list=PLLNmXzyKl-zwA_YCf_jVa4DiF83QrZkwf