Information on what to expect when seeing a psychologist in the pain service assessment pathway for a spinal cord stimulator

Who is this leaflet for?

This leaflet is for patients in the pain service assessment pathway for a spinal cord stimulator (SCS) at Addenbrooke’s Hospital who have been referred to a clinical psychologist in the team. It may also be helpful to share this information with family and /or carers.

What is the aim of this leaflet?

This leaflet aims to explain why a psychology assessment is part of the SCS pathway. We hope the information provided will reassure and inform you. It should answer some of your questions about the assessment process and help you prepare for your appointment to get the most out of it.

Why is there a psychology assessment in the pain service SCS pathway?

The psychology assessment is part of the multidisciplinary team’s assessment for the SCS. The team includes doctors, nurses, a physiotherapist and a clinical psychologist. Together with you, this team will decide if you are ready for SCS.

To support their decision, the multidisciplinary team consider whether your type of pain can be treated with SCS, what you would like to gain from the treatment, your physical health, and how well you cope with your pain in your day-to-day life.

If you and the team feel that you are a suitable candidate for SCS, you will be placed on a waiting list for surgery. However, if another approach is likely to be more suitable, an alternative plan will be discussed with you depending on your individual needs.

From a psychological perspective, there are certain reasons why now may not be the right time to start SCS. These include:

• If you are not already using self-management techniques for persistent pain.
• If you view the SCS as a cure for your pain, rather than a way to help manage it.
• If you have significant psychological issues or challenging social circumstances which would mean you might struggle with your recovery. If so, these may need to be addressed prior to surgery.

What happens when you meet a psychologist?

Most people will meet a psychologist as an outpatient. Your appointment can be in person in an outpatient clinic room, by telephone or video call depending on your circumstances and preferences.

The length of the meeting will often vary depending on your needs and wishes, but would not normally be more than one hour. Some people will want to meet with a psychologist on their own, but it can also be helpful to meet with family members or friends.

Some topics you are likely to be asked about include:

• Your experiences of persistent pain and how this impacts your thoughts, feelings, emotions and daily activities.
• Any stressful life events which could be impacting your quality of life and your experience of persistent pain.
• Significant emotional experiences and how they affect you in the ‘here and now’.
• Previous psychological treatment or support in your management of persistent pain.
• Your attitudes towards having SCS as a tool in your self-management of persistent pain.

During the assessment you may be provided with self-help resources including psychological coping skills and strategies, as using these before surgery can help with your recovery. If necessary, you may be referred for sessions of individual talking therapy to give you the opportunity to discuss your personal goals and prepare for SCS surgery.

What will happen to the information shared with a psychologist?

Psychologists follow the same rules of confidentiality as all hospital staff. They are part of the multidisciplinary team and will routinely communicate with doctors and other health professionals involved in an individual’s care. Your assessment letter will be discussed with you before it is sent to your GP.

Psychologists will always record details of their meetings on a patient’s electronic notes. There are occasions when information has to be shared more widely with relevant professionals, such as when a person is believed to be at risk of harming themselves or another person. If you have any concerns about the sharing of sensitive information, please do discuss this with the professional involved in your care.

If you need to discuss any related issues with the team before your assessment, or if you cannot attend a psychology assessment appointment for any reason, please contact the pain clinic on 01223 216993 to cancel or reschedule the appointment.

Please note that if you do not attend your appointment without informing the pain clinic, you will be automatically discharged back to the referrer and will need to be re-referred, which can result in a significant wait.

For further details of the SCS pathway, see these national guidelines: Spinal cord stimulation for the management of pain: recommendations for best clinical practice (British Neurological Surgeons, 2009) (opens in a new tab).