This leaflet answers common questions about the plastic surgery psychology service and how you can access it. The service is for patients under the care of the plastic surgery department.

What do psychologists do in the plastic surgery department?

As psychologists, we are interested in the emotional and psychological impact of physical health conditions, illnesses and injury and aim to help reduce distress and improve the wellbeing of patients.

We are a team of registered practitioner psychologists and trainees, and we work with people under the care of the plastic surgery department. A psychologist from our team gets involved in care for several different reasons.

One area where we provide support is around the surgery:
• To help you be clear about your expectations of surgery and whether surgery can achieve these changes.
• To support you to decide about surgery or the type of surgery.
• To help you prepare for the surgery or care routine following surgery, particularly if you have specific worries.
• If you are seeking a cosmetic surgery procedure.

We also support people (sometimes alongside their close friend, family, or carer) when they find it difficult to get used to a change in their body. This can happen after surgery or be the result of injury or a disease. We might be involved with your care if you:

  • Feel nervous, worried, or angry.
  • Feel low in mood or upset about the way you look.
  • Feel like you want to avoid certain situations, for example being in crowded places or going swimming.
  • Have concerns about entering relationships or making new friends.
  • Find it hard to adjust to a change in appearance, even when the change is positive.
  • Feel upset about the way their body feels after surgery.

Some of our work is with people who struggle with the reasons that lead them to be cared for by the plastic surgery department, such as having had surgery to remove disease, following an accident or injury or having a medical condition that leads to changes in the body.

We see people who:

  • Feel shocked and struggle to stop thinking about what caused them to look different.
  • Are concerned about changes in their behaviour or reactions to certain situations.
  • Feel more stressed after their procedure or injury.
  • Have concerns about work or relationships.

Patients often find that working with a psychologist can make a positive difference to the way they manage changes and reduce the interference this has in their daily life.

Who provides the service and where?

We are a team of registered practitioner psychologists and trainees. We offer assessment, advice and time-limited (short-term) talking therapies to people receiving care from the plastic surgery department. Our team works primarily with individuals, though significant others (family, carer etc.) occasionally join our conversation. We may also sometimes join other members of the plastic surgery team in their consultations with you.

Our outpatient clinic 4 is located at the Royal Free Hospital. We are also able to see inpatients in the hospital and, if appropriate, offer virtual appointments for ongoing treatment.

How can I see a psychologist?

If you wish to be seen by a psychologist, please speak to any member of the plastic surgery team, including your nurse, hand therapist, or your consultant. You can also contact us directly; contact details can be found at the end of this leaflet.

Sometimes a member of the plastic surgery team will ask for the psychologist to meet you to see if the team can be of assistance during your treatment. We can meet with people on the ward or in the plastic surgery outpatient clinic. If you are offered ongoing psychological care, and if appropriate, this could also be done through online consultations.

What happens once I am referred to the team?

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, what changes you have noticed, the impact of these and what might by ways in which you have attempted to help yourself to manage these difficulties.

We will also discuss any other support you have or might want after your discharge from the ward or team. It will also be an opportunity to 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 appointment 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.

If you feel it could be beneficial for someone to attend a meeting with you, such as friend or family member, they would usually be allowed to attend. This may be subject to any infection control guidelines in place, please check with the team when your appointment is booked for further details.

A follow-up appointment with a psychologist usually lasts 50 minutes.

Is what I discuss with the team confidential?

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. 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.