This leaflet answers common questions about the cardiac rehabilitation psychology service and how you can access it. The service is available to cardiac rehabilitation patients at the Royal Free Hospital and Barnet Hospital who are under the care of a Royal Free London cardiology consultant.

If you would like further information, or have any particular worries, please do not hesitate to ask your nurse or doctor.

How can the psychology service help you?

When you are diagnosed with a heart problem or experience a cardiac event (such as a heart attack) it may affect you emotionally in a variety of ways. Talking therapies can help you make sense of difficult emotions, thoughts and behaviours such as:

  • Shock, confusion or feeling overwhelmed
  • Anxiety and/or panic attacks
  • Post-traumatic stress disorder and/or trauma symptoms such as intrusive thoughts, repeated distressing images or nightmares • Emotions such as fear, sadness, anger, feeling lost
  • Low mood and/or depression
  • Worries about changes to your body
  • Concerns about treatment, procedures, or operations
  • Managing a health diagnosis and doing what you have been advised to do
  • Worries about the future, fear about ill health and dying
  • Worries around the potential impact on personal relationships, family and friends, work, study, or other areas of your life

For some people, having health problems can bring up difficult memories from a long time ago or other problems in their life can make it more difficult to manage cardiac problems and medical treatment.

The above list is not exhaustive, and these experiences are not unusual. Often, they pass with time; however, for some they can be persistent and distressing. Seeing a psychologist may help you make sense of your experience, by providing a space to talk

Who provides the service and what does it involve?

The service is part of the Royal Free cardiac rehabilitation psychology service and involves a specialist psychologist offering time-limited (short-term) one-to-one talking therapies.

The talking therapies vary, and can include cognitive behavioural therapy (CBT), eye movement desensitisation reprocessing (EMDR) and compassion focused therapy (CFT). Your psychologist will explain the different types of therapies to you, and you will be supported to make the choice of talking therapy that suits you. Further information about talking therapies can be found at the end of this leaflet.

How can I be referred to the cardiac psychology service?

To arrange a referral, please speak to a member of staff on the cardiac ward, the cardiac rehabilitation team, or talk to your cardiology consultant. You can also call the service on 020 7830 2871, extension 33145 or email rf.cardiacrehab@nhs.net.

The psychology clinic currently runs on Monday and Thursday mornings at the Royal Free Hospital and Wednesday afternoons at Barnet Hospital.

What happens once I am referred to the cardiac psychologist?

Following your referral, we will arrange an initial 50-minute assessment appointment. During this session you will have the opportunity to discuss the issues that are concerning you and get to know your psychologist.

In some instances, a community-based service may be the best place to meet your needs and the psychologist can help you access this. Please note that attending a psychology assessment does not mean that you will automatically receive therapy.

If you require an interpreter or help with mobility, hearing, or sight, please let us know and we will make the appropriate arrangements.

Confidentiality and how your records are treated

The things you talk about in your appointment will remain confidential between you and the psychologist you are seeing, and the clinical team (the doctors, nurses or other clinicians in your care).

Information about your appointment, including details of what you discussed with your psychologist, is stored on the trust’s electronic patient record.

This record would also include any email exchanges or telephone contact you may have, or conversations the psychologist may have with others about you. Your psychologist will also write to your GP or referring service providing them with similar information.

If there is something you would prefer the team not to know, then please let your psychologist know so that you can discuss this and work out what is most helpful. There is an option of certain information being stored in a secure folder that only the psychologist or counsellors working in the Trust can access.

We will not share your information with professionals or organisations not involved in your care without your consent.

The only time we can share information without your agreement is when we feel that doing so would protect you or someone else from serious harm, or if we are required to do so by law and in such instances, they will try to let you know and hopefully find a way of involving others in your care with your agreement.

If you have any questions about how your information is shared please speak to your psychologist.

What if I have complex mental health difficulties?

If you have complex mental health difficulties, suicidal thoughts or self-harming behaviours, specialist services in the community are more appropriate for your needs.

The psychologist or your referring service can explain this further with you and put you in touch with the people who can provide you with the best support.

The cardiac rehabilitation psychology service is not a crisis/emergency service and cannot provide a rapid response in a mental health crisis.

If you require urgent mental health support, please contact 111/999, contact your GP or go to your nearest emergency department.