The role of the psychosocial team in kidney treatment

Although most of the patients at Great Ormond Street Hospital (GOSH) are being treated for physical problems, emotional health is a key factor in a child’s recovery.

The renal psychosocial team at GOSH offers specific support for children with kidney problems and their families.

By making themselves available to hear the concerns of families, the team plays a crucial role in making sure that their emotional needs are being met alongside any physical treatment.

The team (which includes family therapists, a social worker and clinical psychologist), aims to meet families at times of key treatment changes (such as when transplantation is being discussed), as they know these can be very challenging (emotionally, practically and financially) for families.

They can also help if children develop emotional or behavioural problems linked to their illness or treatment.

Regular visitors

Providing support to families is not always an easy task, and the renal unit poses a unique challenge for the team, given the cyclical nature of the child’s relationship with it.

During their time on the renal unit, patients may be treated for chronic renal failure and subsequently need dialysis followed by a transplant.

During dialysis, patients will generally come to the hospital three times a week for several hours at a time. Although having a transplant means this is no longer needed, it is by no means the end of the journey, because sadly all transplants have a limited life.

At the moment our doctors estimate that a donor kidney lasts between 10 and 15 years. For all our patients, therefore, the new kidney’s function will deteriorate over time, so that the patient requires dialysis again and ultimately a second transplant.

The ability to offer a child a transplant and a normal childhood is incredibly important, but eventually the family will have to face the reality that their child will once again need dialysis, and this can be tough for all concerned.

This is just one occasion where talking to a members of the psychosocial team may be of benefit to both patient and family.

Opening up

The experience of having a child who needs to be in hospital for an extended length of time produces a mixture of feelings. These might include anger at the injustice of their child having to undergo painful procedures as well as feelings of loss around the healthy child and parenting experience that, during pregnancy, they had imagined and anticipated having.

Not everybody is happy to talk and the team respects the rights and wishes of parents to deal with the situation in their own way. Many men in particular are reluctant to engage in a formal counselling session. However, by just offering a friendly face they can chat to in the corridor, the team can often help in a less structured way.

Talking to parents is an absolutely vital part of nursing, but sometimes resource constraints mean that this isn’t always possible, especially given the high numbers of patients on the renal unit who require high dependency care.

Having a dedicated psychosocial team available means that that resource is always available when a parent needs it.