Clinical psychology

Psychologists work with people who are experiencing difficult things. Some psychologists specialise and work in health settings. They help people to manage their health condition and reduce the impact it is having on them and their lives.

Psychologists work with people to help them find ways of managing their condition, so that they reduce the effect that their condition is having on their lives. This can help them to move forward with their lives. Being referred to a psychologist does not mean we think that your symptoms are not real or that they are ‘all in your mind’. The Facial Pain Service psychologists work with people to help them reduce the physical and emotional effects of their pain or oral condition.

Facial pain and other symptoms can affect people in many ways, not just physically. For example, some may worry about what is happening to their face or body. It may stop them doing certain activities such as eating in public, going out in cold weather or moving their jaw because they are worried about their pain increasing or that something else might happen. Unfortunately, reducing movement can lead to weak muscles and stiff joints. This can make things even harder. People who have pain may stop or reduce work, social life or hobbies because the pain feels too much and they feel they can no longer manage these situations. This can affect how people feel. For example, people often say they feel angry, frustrated; low in mood and lack confidence.

Many people who are referred to psychology are asked to attend an information session. This is a group session led by a psychologist and physiotherapist. They will help you to understand more about facial pain and other symptoms and explain what the service has to offer you. If you are invited to this session, it is important that you attend. Many people tell us that they feel quite worried about being in a group of people but are surprised how informal it is and how helpful they found it. If you would like to have an assessment by a psychologist after this session we can arrange an appointment for you. This appointment will help us learn more about you and your pain. It will also help you understand what we can offer you. This appointment will take 50 minutes and will be with just you and the psychologist.

It is helpful if you can tell us about:

• The way the pain affects you and your life and other people
• What you understand or have been told about your pain, what you think the causes are and why you continue to experience pain
• How you would like your life to be different in spite of pain

We will ask you about your life in general, such as how you spend your time and what you enjoy doing. Having a better understanding of you and your life helps us work with you. At the assessment the clinical psychologist will discuss your goals with you and you both decide the next step. This could be the About Face Pain Management Programme, individual psychology sessions or a referral elsewhere. A booklet is available if you would like further information about the Pain Management Programme.

If you decide on individual psychology sessions we will discuss your goals with you and agree on the number of sessions. Each session lasts for 45 minutes. People have between two and eight sessions, these can be weekly fortnightly or less frequent. It all depends on your needs. The psychologists in the Facial Pain Service use cognitive behavioural therapies (CBT) to help reduce the effect that the pain is having on you and your life. The aim is to help you to feel more confident in managing your pain. As a consequence of feeling more confident about managing your pain you may begin to experience improvements in your mood, social life, fitness and your ability to do activities despite your pain.

CBT looks at the relationship between thoughts, feelings, behaviour and what is happening in the
body, including pain. Depending on your goals, the sessions may include topics such as:

• Understanding chronic facial pain
• The impact that thoughts have on mood and behaviour and techniques to recognise and manage
• better with unhelpful thoughts
• Connecting with what matters to you in your life
• Mindfulness
• Dealing with increases in pain
• Improving sleep
• Communicating effectively with others about pain

These are just examples. What is discussed in these sessions depends on your goals. The psychologist does not set goals for you because only you know what you would like to be doing and feeling despite you pain. When working with a clinical/counselling psychologist you will need to practice what you learn at home between each session. In general, the more you practice self-management strategies the more you will gain.

Psychologists working with people with chronic pain do not take away chronic pain. We will help you to develop self-management strategies that reduce many of the effects of chronic pain. Research shows that cognitive behavioural therapy for pain is very effective and has very good results in reducing the effect the pain has on people’s lives.

• Eccleston C, Williams ACDC, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews 2009, Issue 2.Art. No. CD007407. DOI: 10.1002/14651858.CD007407.pub2.
• Health Experience Insights – Chronic pain
• The British Pain Society
• The Samaritans – A national organisation offering support to people in distress who feel suicidal or despairing
  Helpline: 08457 90 90 90

UCLH cannot accept responsibility for information provided by external organisations.

Facial Pain Clinic
47–49 Huntley Street
London
WC1E 6DG

Psychologists’ Secretary: 020 3456 1053
Switchboard: 020 3456 7890
Email: uclh.enquiry.facialpain@nhs.net

PALS is a patient-friendly, easy to access service designed to provide a personal contact
point to assist patients, relatives and carers. If you have a problem that you have not
been able to sort out we can help you to resolve it.

The PALS office is located in the main atrium of University College Hospital, 235 Euston Road, London, NW1 2BU.

PALS are open: Monday to Friday: 10:00 till 16:00
Telephone: 020 3447 3042
Email: uclh.pals@nhs.net

Royal National ENT and Eastman Dental Hospital
47–49 Huntley Street, London WC1E 6DG

Huntley Street is close to Euston, Warren Street and Goodge Street Underground Stations and there are bus stops nearby. Apart from limited disabled parking there is no car parking at the hospital. You are advised to travel by public transport.