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Psychological Medicine

The Psychological Medicine team consists of doctors and psychologists who help children with a combination of physical illness and symptoms, and mental health difficulties.

We also run the national Tourette syndrome clinic.

About the Psychological Medicine team

We particularly work in the overlap between neurology and psychiatry/psychology, so we have a neuropsychologist (Dr Tara Murphy) and a neuropsychiatrist (Dr Isobel Heyman) on the team.

We also work to help children where medical tests have not fully explained the severity or impact of symptoms: ‘medically unexplained symptoms’, helping detect and treat any psychological difficulties and maximising function. 

We are happy to receive internal or external referrals from professionals, where there are concerns about the mental health of a child with physical illness/symptoms. Other members of the department may be involved in the assessment and treatment of children and families depending on individual needs.

A key step is detecting and diagnosing a mental health problem if it is present. They can often be common difficulties such as depression, anxiety, attention deficit/hyperactivity disorder, or behavioural problems. These problems have effective treatments that have been tested and are known to work, which are often called evidence-based, and these are our first-line treatments.

All children with long-term physical illness may have mental health needs. But children with neurological symptoms and problems are even more likely to often have emotional, behavioural and learning difficulties than children with other conditions. These psychological problems often have a significant impact on both the child and their family, and their school experience. These problems are nobody’s fault and may be related to the underlying neurological problem, but they are often easily treated.

What do the Psychological Medicine team do?

  • We aim to identify emotional, behavioural and learning difficulties, and to offer the best, most effective treatments.

  • We work closely with paediatricians, neurologists and other doctors so that psychological treatments are a fully integrated part of overall care. 

  • The children and adolescents we work with are aged 0-18 and have physical illness and/or symptoms, especially neurological problems.

  • We get involved because emotional, behavioural and learning problems are getting in the way. 

Examples of the difficulties we work with include:        

  • epilepsy

  • non-epileptic seizures

  • neurological symptoms that may be related to stress eg conversion

  • stroke

  • encephalitis

  • head injury

  • demyelinating disorders

Paediatricians, neurologists, psychiatrists and other health professionals may ask for our input in assessing any emotional, behavioural and learning difficulties. This might be because a child is unhappy, angry, withdrawn or tired, to the extent that it is affecting daily life.

Assessment

A detailed assessment will be carried out to identify any problems. This might include:

  • a detailed clinical assessment with psychiatrists, psychologists and other members of the team

  • linking with other mental health teams in the hospital with additional expertise

  • psychological assessments, which might include neuropsychological testing. These are puzzles and games that look at individual strengths and weaknesses.

Treatment

Treatments will be tailored to the individual needs of the child and family and in general will be: 

  • targeted to the most important areas of difficulty, for example anxiety, depression and disruptive behaviour disorders

  • evidence-based, which means they have been tested and shown to work

  • as short and intensive as possible to achieve maximum effect

  • linked closely with other teams in the hospital or community who are also involved in looking after the child and family

Depending on specific needs identified in the assessment, treatments may include a range of therapeutic approaches and medication if appropriate.

These may include:

  • cognitive behaviour therapy, usually closely involving parents

  • psychological treatments for tics, including habit reversal therapy

  • parent training/behaviour management strategies

  • medication if needed

We coordinate an intervention service which can deliver the above treatments to any child attending any team in our department or the wider hospital. 

Therapists for this service include:

Dr Laura Markham
Clinical Psychologist

Dr Eve McAllister
Clinical Psychologist

Other team members

Dr Isobel Heyman
Consultant Child & Adolescent Psychiatrist

Dr Tara Murphy
Consultant Clinical Psychologist

Dr Fiona McFarlane
Clinical Psychologist

Dr Daniel Stark
Clinical Psychologist

Professor Roz Shafran
Professor of Translational Psychology and Honorary Consultant Clinical Psychologist

Corinne Borley
Team Administrator

Outcomes

We hope that you will find our service useful and find that it improves difficulties. In order to discover whether our treatments are helpful and effective we will ask you to complete questionnaires before, during and after treatment.

Research and publications

We have an ongoing programme of research, and you or your child may be invited to take part in a research project whilst under the care of the team. This is always entirely voluntary, and whether you choose to participate or not, your clinical care will not be affected. Any information gathered may be used anonymously for research purposes to improve our understanding and lead to better treatments for other children and families in the future.

See a list of some selected publications from the Psychological Medicine team members.

Referrals

Please make referrals in writing and post or email to Dr Isobel Heyman via Corinne Borley.

Corinne Borley, Team Administrator
Department of Child and Adolescent Mental Health
Level 4 Frontage Building
Great Ormond Street Hospital for Children NHS Foundation Trust
Great Ormond Street
London WC1N 3JH

Tel: 020 7405 9200 ext 5778
Fax: 020 7813 8411
Email: Corinne.Borley@gosh.nhs.uk