Cleft Psychology Team

This leaflet aims to explain the role of psychology within the cleft team. Psychology support is available to everyone born with a cleft lip and/or palate and their families.

What is a clinical psychologist?

A clinical psychologist is interested in understanding and working with how people think, feel and behave. Our team will work with you, or members of your family, to build a shared understanding of your/ your child’s current difficulties and what might have contributed to them starting in the first place. We will support you to better understand your emotional experiences, think about ways to help improve how you are feeling and help you to re-engage with things that are important to you. Our team try to help people adjust to and cope with all sorts of challenging situations.

Why would I need to see a clinical psychologist in the cleft team?

In the cleft team, we understand that having a cleft lip and/or palate, and having the associated treatment, can at times be challenging for some individuals and their families. Not all individuals born with a cleft lip and/or palate will need to see a psychologist.

Below is a diagram which illustrates some of the key areas in which our team can support you or your family.

We can support individuals born with a cleft lip and/or palate at any stage during their life as detailed below.

Antenatal support for expectant parents

If your baby’s cleft lip is identified at the 20-week scan, you will receive support from one of our cleft nurses who can provide you with lots of information and guidance. Psychology can offer expectant parents a space to process the diagnosis and get ready to welcome their baby.

Postnatal support for parents

Our team can also support parents of babies whose cleft lip and/or palate was not identified at their 20-week scan and was identified at birth. As well as helping parents adjust to this diagnosis, we can also support parents to understand and manage their emotional reactions and expectations around their child’s upcoming surgery. Psychology sessions aim to provide parents a safe space to process the emotions associated with these surgeries, as well as any perceived future challenges they may anticipate for themselves and/or their child.

Speaking to your child about their cleft

Within the cleft team, we will encourage and support parents to speak to their child about their cleft, because we know that children owning and understanding this information is a key foundation to confidence. We can provide resources to help you with these conversations. We hope that by the age of five years old, your child will be able to talk about their cleft in their own words.

Psychological impact of having a cleft: young people and/or parents

Some children who were born with a cleft may find psychological support helpful as they grow up.

Our team can support individuals who might feel worried, sad or frustrated about their appearance, speech and/or hearing. Similarly, children and adults born with a cleft may find certain situations or transitions more challenging. We aim to help individuals process these emotions and think about strategies to help make these situations more manageable.

Support around upcoming medical procedures

Throughout the cleft pathway, individuals may be involved in different medical procedures such as dentistry or orthodontics. Some young people and adults can find these medical appointments anxiety provoking. If this is the case, we can offer support from our team to think about strategies to manage any worries around these appointments.

Future surgery decisions

Throughout the cleft pathway, there may be decisions to be made about possible additional treatments and/or surgeries and our team can offer to support to help prepare for these assessments and procedures.

Adult returners

Our routine cleft treatment pathway ends around the age of 18. However, some adults will return to the cleft service for additional treatment or psychological support. This support might for example be around the impact their cleft has had, or is continuing to, have on their life or wellbeing or to think about additional surgery and treatment options.

When will I meet a clinical psychologist?

Clinical psychologists in the cleft team are present at routine cleft clinics and at key time points throughout the cleft pathway, including the five-year review.

If a professional refers you to the psychology team and you are happy with the referral, you will be added to our waiting list. As soon as we have availability, we will contact you to arrange an initial appointment. This will be a chance for you or your child to meet a psychologist to start to build a shared understanding of your current worries or difficulties by getting to know you a little bit more. The first appointment typically lasts between 60 and 90 minutes and can be by telephone, video call or in person in the hospital. Following the initial session, we will consider some ways forward, for example, arranging further sessions or directing you to other, more appropriate, services.

Once agreed together, support from our team will be through individual sessions, sessions with family members or joint sessions with you and a parent/ carer.

Sometimes, we might also want to speak to other professionals who support you to gather more information. This could be your GP, school, social services or other medical teams. We will always ask whether you are happy for us to contact them first.

For some individuals, the psychology team might offer signposting to more appropriate services which can offer non-cleft related support. As a team, we liaise closely with both child and adolescent and adult mental health teams. Your GP may also have suggestions on avenues of support for non-cleft related difficulties or questions.

Confidentiality and consent

Confidentiality and consent will be discussed with you at your first meeting with a psychologist; you will have the opportunity to ask any questions.

All information that you share with a psychologist is treated confidentially, unless there are concerns that someone’s safety is at risk.

Therapeutic letters are exchanged between members of the cleft team, so that we can provide you with the best care. These letters are also sent to your GP. However, if there is any information that you do not want to be shared with the rest of the team, you can discuss this with your psychologist.

How do I contact the cleft psychology team?

If you or your family have any questions about the psychology service, or if you would like to discuss whether psychology could support you, please feel free to contact us on 01223 596272. You can, of course, also speak to any member of the cleft team who will put you in contact with us.

Address: Cleft.NET.East, Box 106, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 2QQ

Email Cleft referrals or Email Cleft.Net.East

Please note: if your concern is urgent, or your situation changes, contact your GP or your local crisis team.

Further information

For further information about the service and the team, please visit the Cleft.NET.East webpage.

Useful websites

There are a number of websites to help parents and children with cleft lip and/or palate. A few of these are listed below:

• CLAPA (opens in a new tab)
• Kidscape (opens in a new tab)
• Childline (opens in a new tab)
• Changing Faces (opens in a new tab)
• NHS 111 (opens in a new tab)