Paediatric Health Psychology Service
Referral Guidelines
A Paediatric Clinical Psychologist specialises in child health and health related
psychological issues. We recognise the impact illness can also have on a child’s family
and the professionals involved in their care. We provide a consultation service to the
professionals involved in a child’s medical care. We also offer assessment and
intervention in specialist cases where more intensive input is required.
After consultation has taken place, a child can be referred to the Phoenix Centre using
the CAMHS referral form, please follow the link below:
http://www.nhshighland.scot.nhsuk/Services/Documents/CAMHS%20Referral%20Form.
doc
The child will then be placed on a Paediatric Health Psychology waiting list.
The Paediatric Clinical Psychologist based in Inverness is Dr Tracy McGlynn. Doctoral
Trainee Clinical Psychologists and Assistant Psychologists also offer input into this
service.
Services offered
We aim to deliver services following a stepped care principle. Needs may be met in any
of the following ways:



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Consultation to those professionals involved in the child’s care
Assessment of the child or family’s presenting difficulty
Specialist intervention (such as helping a child adjust to the psychological
implications of a change in body image as a result of injury/treatment/illness).
Staff support
The primary role of the Paediatric Health Psychology Service is to engage in
consultation and liaison with medical colleagues. We also have a limited capacity to
provide specialist therapeutic interventions.
How to refer
In the first instance, referrals can be discussed informally by contacting Tracy McGlynn
at the Phoenix Centre. Referrals can be made by any of the hospital medical team
involved in a child’s care. Tracy is also available to speak with at the psychosocial
meeting on the Children’s Ward at 2-3pm most Wednesdays.
If a referral is considered appropriate after discussion, please complete the CAMHS
referral form accessed via link below:
http://www.nhshighland.scot.nhsuk/Services/Documents/CAMHS%20Referral%20Form.
doc
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 1 of 8
Paediatric Health Psychology Service
Referral Guidelines
Any child under the care of a Consultant Paediatrician can be referred to the Paediatric
Health Psychology Service, with the following exceptions:

We do not accept referrals for children whose difficulties are not associated with
their medical condition or problems e.g. toileting or sleep difficulties unrelated to
any paediatric condition.

We would not see children presenting with a psychiatric diagnosis or significant
psychological distress that is unrelated to a physical health problem. The needs
of this client group are best addressed by our colleagues in general CAMHS.
Stepped Care
The main principle of stepped care is to provide an intensity or level of intervention that
is matched to client need.
The aims of this approach are to:
 Maximise client engagement and involvement
 Support staff and enhance skills in delivering psychologically informed
interventions
 Maximise efficiency in the referral system
Step 1
Training
CONSULTATION
Step 2
FORMULATION
Step 3
SPECIALIST
PSYCHOLOGICAL
INTERVENTION
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 2 of 8
Paediatric Health Psychology Service
Referral Guidelines
Step 1 – Consultation to professionals
Consultation provides a safe space to discuss issues of concern, either on a regular or
as and when basis. The main purpose of consultation is to establish a preliminary
formulation, inform decisions on the level(s) of intervention required, and inform care
planning and review.
The types of issues discussed in consultation include:


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
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Facilitating effective communication with the patient, the family or colleagues
Patient physical/emotional/behavioural difficulties
Difficulties engaging in/stabilising in or adhering to medical treatment
Difficulties/barriers in relationship with patient or family
Understanding risky/acting out behaviours
A feeling of ‘stuckness’ in a case.
Supporting staff with personal issues (where they impact on clinical work)
Organisational issues such as resources, team morale etc (where they impact on
clinical work)
Child Protection concerns
Consultation has the potential to highlight training needs that the Paediatric Clinical
Psychologist may be in a position to offer input into. We welcome training requests.
Consultation & confidentiality
Most patients usually understand that information about them has to be shared within
the multi-disciplinary healthcare team to provide their care. Information should be readily
available to patients explaining that, unless they object, personal information about them
will be shared within the healthcare team, including the Paediatric Clinical Psychologist.
We have a number of responsibilities regarding confidentiality during consultation.
These include:

A responsibility to the person seeking consultation to keep consultation sessions
confidential.

A responsibility to those clients discussed to keep their details confidential.

A responsibility to the organisation or regulatory body of which the person
seeking consultation is a member of to break confidentiality if that individual is
acting unethically so as to prevent harm to the patient.
In line with British Psychological Society Code of Ethics, a brief written record will be
kept of all consultations to staff.
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 3 of 8
Paediatric Health Psychology Service
Referral Guidelines
Step 2 – Formulation
The child or family will be offered an appointment to meet in the Birnie Centre, or
Phoenix Centre. The purpose of this appointment is to draw on psychological theories to
try and provide a framework for understanding a problem, how it developed and how it is
being maintained.
A formulation appointment would be suggested if:

Consultation has been unable to provide a preliminary formulation and care plan

The child is likely to require a step 3 intervention
Or
Following a formulation appointment we would hope to be able to provide thoughts and
suggestions to those involved in the child’s care. However, in some cases we may
recommend placing the child on the Paediatric Health Psychology or CAMHS waiting
list, depending on the nature of the difficulties identified.
Step 3 – Specialist Psychological Intervention
Referral is made by a member of the hospital medical team. Inpatient and outpatient
interventions are offered for difficulties that have arisen in relation to a medical condition.
In regards to inpatient contact, a psychology slot is available on the Children’s Ward
from 4-5pm weekly. The aim is that this session can be incorporated into planned
admissions when needed. Advance warning of at least two weeks is normally needed.
Please contact Tracy McGlynn by email or phone directly to discuss further.
WHAT WE CAN OFFER
Child or young person

Addressing behavioural and/or emotional difficulties which are associated with
physical illness/symptoms

Trauma based work to address any experiences that have been felt as
overwhelming to the child/young person or family.

Fostering feelings of motivation in a person struggling to adhere to their
treatment regime.

Thinking about choices about treatments and/or life changes e.g. cessation of
treatment, changing to special needs school. Preparation for hospitalisation,
painful procedures & surgery.

Consideration of effects of physical illness/symptoms on a child or young person
at present and in future and providing opportunities for open discussion, e.g.
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 4 of 8
Paediatric Health Psychology Service
Referral Guidelines
infertility, change to physical appearance and body image, life-limiting
implications, adjustment to diagnosis and treatment regimes, informed consent
and participation, end of life concerns.

Assessment of cognitive, learning and specific functions e.g. to assess impact
and progression of illness, to assess levels of functioning to inform future care
and treatments, including self-medication in e.g. diabetes.

Supporting a child or young person through transitions, e.g. child to adolescence
to adult services, hospital to home, specialist to local services.
Parents/Carers

Coping with own thoughts and feelings about their child’s illness and/or physical
symptoms. Awareness of impact of own emotional well being on child’s illness.

How to answer questions put by child with physical illness and those of friends
and family members.
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Preparing and supporting child for future treatment/changes in life style.
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Negotiating role as a parent of a sick child at home, outside home and in medical
settings.
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Balancing the demands of parenting a sick child with other aspects of family
need and functioning as well as meeting the needs of other family members. This
may include considering sibling’s feelings about the illness and the implications
for their life.

Helping in preparation and support if siblings are directly involved in sibling’s
treatment, e.g. sibling donors in bone marrow transplant.
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Help communicating understanding the nature of the physical illness and/or
symptoms

Dealing with transition, paticularly adolescence and how to give child/young
person greater independence.
Parents/Carers of a child in Special Care Baby Unit (SCBU)

Tracy McGlynn provide a link to SCBU as well as to the Children’s Ward. A
weekly neonatal psychosocial meeting is held from 3-4pm every Wednesday.
This allows discussion among the team about the potential role of psychology in
helping families whose baby is currently cared for in the unit. One off
appointments to parents/carers can be sought by any of the medical team by
making direct contact with Tracy with the parent’s consent.
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 5 of 8
Paediatric Health Psychology Service
Referral Guidelines
Colleagues

Attendance at clinics when there are complex adherence or adjustment cases.

Consulting to paediatric teams on ways of screening for psychological difficulties
in children and families.

Attending a ward round/clinic/psychosocial meeting to consider family and
systemic perspectives.

Teaching staff about children’s development and emotional/behavioural needs.

Contributing to the development of protocols, guidelines or care pathway
guidelines.
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Providing reflective practice opportunities for staff over difficult situations.
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Involvement in debriefing or support opportunities for all staff when a child’s
death occurs, or when terminal care is being planned.
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Facilitating group discussions in high stress situations
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Working with others (e.g. senior nurses, play specialists etc) to develop policies
for children’s care, e.g. preparation for procedures.

Offering opinion on complex cases such as suspected fabricated or induced
illness (FII) in a child by a carer.
DIFFICULTIES BETTER
PSYCHOLOGIST
ADDRESSED
BY
CAMHS
THAN
A
PAEDIATRIC
In some cases a child’s needs might be more appropriately met by the general CAMH
Service than by the Paediatric Health Psychology Service.
Our role is primarily to work with children and families where the identified problem is
related to their physical health condition (e.g. adjustment difficulties, treatment issues
etc).
Sometimes a child or young person with a diagnosed medical condition may have
psychological difficulties that are not directly related to their medical condition. For
example, difficulties may result from interpersonal issues. Whilst we may not be able to
offer direct input, we can still offer consulation if required.
Every so often there are cases where a child presents with physical symptoms and no
medical cause can be found. In such cases there may be a role for a Paediatric
Psychologist, for example working on pain management with the child. However if it is
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 6 of 8
Paediatric Health Psychology Service
Referral Guidelines
thought that the symptoms are attributable to a known significant stressor in the child’s
life, such as a bereavement, their needs may be best met by CAMHS.
Sometimes we may not know which part of the service a child is best seen in, until we
have had a chance to meet with a family, so there may be times when we recommend
referral to CAMHS after we have met with a child or family for a formulation appointment.
For this reason, we have a generic CAMHS referral form, accessible online –
http://www.nhshighland.scot.nhsuk/Services/Documents/CAMHS%20Referral%20Form.
doc
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 7 of 8
Paediatric Health Psychology Service
Referral Guidelines
Paediatric Health Psychology Summary Guidelines
Cases appropriate for referral to Paediatric Health Psychology
We accept referrals for emotional and behavioural difficulties that have arisen in
relation to a medical condition in the child or parent/carer which may include:
 Adjustment to diagnosis
 Treatment compliance
 Anxiety related to medical procedures/treatment
 Preparation for surgery
 Considering treatment choices
 Pain management
 Hospitalisation/medical trauma experienced
 Physical appearance/body image concerns relating to condition or treatment
 Coping with loss
 Cognitive assessment related to health condition or injury
 End of treatment, including transition to adult services
Cases more appropriate for CAMHS


Children with a diagnosed medical condition whose psychological difficulties
are not primarily related to their physical health.
Cases where there is no medical explanation for symptoms and it is thought
the child’s presentation is related to a siginificant stressor in their life.
Consultation or a formulation appointment may be necessary to establish
whether these cases are more appropriate for CAMHS.
How to access the Paediatric Health Psychology Service
Dr Tracy McGlynn, Clinical Psychologist works Tues-Friday, you can telephone to
discuss
a
case
on
the
number
below
or
email
via
nhshighland.phoenixcentre@nhs.net
If you wish to refer a child to us, please complete the online CAMHS referral form:
http://www.nhshighland.scot.nhsuk/Services/Documents/CAMHS%20Referral%20F
orm.doc
or post a paper copy to the address below:
Paediatric Health Psychology Service
Based in CAMHS
The Phoenix Centre
Inverness
IV2 3UJ
Tel: 01463 701336
Paediatric Health Psychology: Referral guidelines
Owner; Tracy McGlynn
Date of Issue: 27/7/11
Version: 4
Date of Review: 7/7/15
Page: 8 of 8