I have worked as a clinical psychologist across paediatric and physical health services. In my experience, I have found that people are often surprised when they are referred onto a psychologist within these settings. They may ask “what does therapy have to do with my health?” or explain that their condition “is real” and “it isn’t all in my head.”
Traditionally in Western medicine, the mind and body have been considered to be separate from one another and they have always been treated separately i.e. you seek medical intervention for your physical health and psychological therapy and/or psychiatric medication for mental health difficulties. But is it that easy to separate the two?
The definition of a long-term health condition (LTC) is “one that cannot currently be cured but can be controlled with the use of medication and/or other therapies”*¹. Long-term health conditions may include:
- Cardiovascular issues (e.g. Hypertension, Angina, etc…)
- Chronic Respiratory conditions (e.g. Asthma, COPD)
- Chronic Neurological conditions (e.g. Multiple Sclerosis)
- Chronic Pain
- Other conditions such as Chronic Fatigue Syndrome, Fibromyalgia, Irritable Bowel Syndrome (IBS), cancer, Medically Unexplained Symptoms etc…
If we look at the evidence, statistics show that 30% of the population in England (approximately 15.4 million people) have a long-term health condition (LTC). Of those with an LTC, 30% also have a mental health difficulty*². So, in fact, the evidence points out an overlap between LTC’s and mental health difficulties such as depression and anxiety.
Through my experiences of working with people living with LTCs, I often hear stories of their: distress and uncertainty about their symptoms; difficult journeys through the healthcare system; experiences of not being believed about their symptoms; feelings of isolation and symptoms impacting on quality of life and reduced activity.
Therefore, to truly understand the impact of LTCs, rather than solely focusing on symptoms it can be helpful to think of an LTC as a biopsychosocial problem. For example, that someone’s experience of a LTC is a combination of their physical symptoms, psychological factors (grief, loss, stress and worry about symptoms, their perceptions of their illness, coping skills etc…) and social factors (support, family circumstances, employment etc…). Each of these factors affects one another and influences the experience of an LTC.
People living with LTCs can work with a clinical psychologist to explore and understand the different factors influencing their experience of health and illness. Therapy can often be their first experience in a long journey through the healthcare system of being listened to and heard. A clinical psychologist can help you to develop coping skills to better manage and adjust to living with an LTC and its emotional impact on your life.
In my work, I use an integrative approach drawing on evidence-based models to fit to the needs of each individual and based on their goals for therapy. Approaches such as Cognitive Behavioural Therapy and Acceptance and Commitment Therapy (ACT) can be useful in helping to improve quality of life and reducing distress around conditions*3. These approaches can help people to move towards living a more meaningful life with an LTC.
Through therapy people living with a LTC can:
- Feel more confident in managing their LTC and taking control oftheir life
- improve their general wellbeing including symptoms of depression and anxiety
- learn skills including relaxation techniques, managing unhelpful thinking patterns, pacing their activity levels, and coping with setbacks
- Improve their relationship and perception of their LTC and their health
- Reconnect with their values and work towards achieving their personal goals
If you would like to consider whether psychological therapy may be helpful for you, then please do contact us.
Dr Kinza Janjua, Clinical Psychologist.
*1 Department of Health. (2010). Improving the health and well-being of people with long term conditions. World class services for people with long term conditions – information tool for commissioners. London: Crown.
*3 Graham, C.D., Gouick, J., Krahé, C., Gillanders, D. (2016). A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions. Clinical Psychology Review, June 46, 46-58. DOI: 10.1016/j.cpr.2016.04.009.
*2 Naylor, C., Parsonage, M., McDaid, D., Knapp, M., Fossey, M. & Galea, A. (2016). Long-Term Conditions and Mental Health: The Cost of Co-Morbidities. London: The King’s Fund and Centre for Mental Health, www.kingsfund.org.uk/publications/long-term-conditions-and-mental-health