We met Enda, systemic psychotherapist, to find out more about his role at CUH.
What’s your role in our hospital?
I’m a systemic psychotherapist. This is a form of psychotherapy and also known as family therapy that seeks to address relationships. It looks at ways of dealing with the interactions of the group and the interactional patterns and dynamics. It enables family members to express and explore difficult thoughts and emotions safely. It helps build on family strengths and work together to make useful changes in their relationships and their lives.
What do you enjoy most about your role?
I work within the persistent physical symptom (PPS) service in the paediatric children`s medicine team at CUH. The project is a new initiative and has been developed based on the idea of how to we bring our services out to the region and make it more accessible. This role aims to offer regional consultation to staff across the region who come in to contact with young people who present with persistent physical symptoms. The post has been very interesting as it is a new development within the service. I have enjoyed getting to meet staff in other areas and getting a sense of how services are set up in other areas. This aspect of the work has been very insightful. This has outlined the complex range of clinical presentations, the demands on services to be responsive and to consider the needs of the child, family and treating team. I have been impressed by the multidisciplinary team approach, the commitment to work together and to consider how to engage with the service as it is a new resource that is now available to them.
The experience of being part of the paediatric psychology team has enabled me to appreciate the day-to-day challenges of working in the different specialties. I have formed close relationships with the team and developed a good understanding of how services are set up and how psychological support is provided
I have been so impressed with the energy, commitment and vibrancy of the staff who work within the services. There is a wealth of experience and there is such a strong sense of compassion and the wish that the young person and family will get the best experience from the service.
Tell us a bit about your CUH journey.
I started working with the team in June 2023 and it has been an exciting opportunity to extend systemic family therapy interventions further within service. I previously worked in the inpatient eating disorder service which is part of the child and family psychiatry department. This new post within the PPS service at Addenbrooke’s offers a great opportunity for me to develop further and be part of the wish to expand family therapy provision within the hospital.
My colleague has provided family therapy within services at the hospital for a number of years and this has been well received. As a family therapist, the family and the system around the young person is a core part of our work.
We are continually looking at how we include the family’s voice in the care of the young person, to see them as a resource and view them as central around how the journey to go forward is possible.
I see the place that a family plays in the care and treatment of children and young people as essential and informs my practice on all levels.
I am also in discussions about how child and adolescent inpatient mental health services can be combined with my other role as a systemic psychotherapist. We are looking at how this will be a part of the new children’s hospital in the future.
The development of the new children`s hospital has offered our service the opportunity to dream and consider how we want to imagine the service in the future.
This has allowed clinicians to come together and try to understand what we are providing within the different children services and collaborate to envisage a future where we work more alongside each other. This is a positive and exciting opportunity, albeit brings many challenges. It brings a renewed energy to the work and has enabled services to consider ways of working more closely together.
Which services and patient groups do you work with?
My post is part of a pilot project and has been set up to provide a regional consultation and input to services within the region.
The services that I come into contact with aim to support children and young people who might present with physical symptoms that have been investigated and have no medical cause for the presentation.
The young person may experience high levels of distress and require emotional and psychological support. This can also impact on the family, and they too require support and help.
The aim of the service has been to reach out to other services across the region and offer support to professionals who are working with these young people. The contact with the different clinical services has helped identify the different level of provision across the region.
The services are open to looking at ways to support these young people, consider the possible gaps within provision and work to develop a greater awareness of how to support this client group. The aim is to offer consultations, regular group spaces to offer complex case discussion or to provide individual or multidisciplinary team consultation where advice or new ideas around the case could be considered. There is also a teaching component and services are keen to support their staff to develop their practice and support them to feel more confident providing care to this client group whose presentation can be challenging at times.
What does a usual day look like?
I have contact with different services and I look to develop an understanding of how their services are set up. As the post is a new initiative, I outline what we are offering in terms of supporting the work with young people who present with persistent physical symptoms.
We are keen to look at how to support staff at all levels, so this is an important aspect to offer. We have had contact with nursing, psychology and medical staff and looked at ways to engage with them. I have also been looking at teaching and training opportunities, offering consultation or providing reflective practice groups.
How do you feel your role benefits our patients?
The project aims to support clinical services across the region to support the work they do with young people and their families. It has been important to consider the patients’ journey and understand the experience of how they access assessment and the treatment. Provided this has been a useful guide to help orientate clinicians to look at how they support the young people who present and be clear what the treatment pathway might be.
It has been key that we fully understand how services are set up locally and consider what is going well and look at what we can offer alongside that.
It is vital that the clients feel that their voice is heard and that the distress they experience is seen as real. The work focusses on acknowledging this distress and considering how to offer support and strategies to manage this. The role allows staff to reflect on how they respond to clients and on how they engage with them. It is also important that we pay attention to the dynamics within the wider systems, (i.e. professional, family, health, education) and the narratives and accounts that can enhance and constrain what is able to be offered and experienced by the young people. By paying attention to the wider contexts, we are able to gain a deeper understanding of the presenting difficulties.
I am excited by this new opportunity, and the post allows new links to be established and to share expertise with each other. This offers the opportunity to create a rich community of practice and be more joined up in what we are doing.
The role offers the opportunity for staff to reflect upon their practice and consider ways to engage with their clients. It offers a space to develop new ways of working and to widen the context around the presenting difficulties. The approach considers ways to help to develop people practice further and consider the challenges that this work might present. The role ultimately offers a way to create greater links between the hospital and the services that are placed across the region.