Patricia McCrystal is a Consultant Psychologist in a Clinical Health Psychology team. Working within the Southern Health and Social Care Trust, she sets up, leads, and grows a new Diabetes Psychology Service for adults living in that area.
What it involves
Diabetes is a highly complex long-term health condition to manage, and psychological wellbeing is an integral part of it.
It is well documented that 1 in 4 people with diabetes will feel diabetes distress. Fitting daily diabetes management into normal living can be a difficult balancing act; it can be overwhelming, exhausting, and tedious.
In my role, I am here to support adults struggling with their diabetes management and help them find ways of making small changes that can hopefully improve their quality of life, both in the short term and the longer term.
Not everyone will want to attend our psychology service and other people may not feel ready to attend for psychological support, which is completely okay.
The role itself is hugely varied – I love this aspect! I run my assessment clinics where, if a person is attending for the first time, I’ll ask quite a few questions about their diabetes and other parts of their life to gain a full picture. Together we decide on whether attending my service is suitable for their needs.
I also run review clinics for people who wish to make changes in their diabetes self-care, with the aim of improving their overall quality of life. I offer a safe, quiet space for people to share their diabetes challenges and can help with areas such as improving sleep, blood glucose control, managing activity levels, and monitoring or dealing with stress.
I also deliver a ‘Wellbeing Matters’ workshop for those who want to attend after completing the DAFNE course and deliver presentations at various diabetes-related events. I am planning to offer a two-hour Wellbeing Workshop for all those who have recently completed the DESMOND programme and are interested in reflecting on the emotional aspects of managing their Type 2 diabetes. My plan is to promote my new service as a self-referral service, although of course, other colleagues such as Diabetes Specialist Nurses, Dieticians and Consultants can also still refer people in.
As I mentioned, the role is extremely varied, in addition to everything mentioned above, I also supervise Trainee Clinical Psychologists who contribute significantly to our clinics and service development, and of course, answer lots of emails, and calls, and keep on top of lots of paperwork! I really enjoy attending meetings with other professionals to share and develop good practices and advance the quality and consistency of diabetes care.
A welcoming, safe space
As I am only in the process of setting up our Diabetes Psychology Service, my challenges relate to understanding how I could best serve those who wish to attend.
This has required me to study diabetes, shadow Diabetes Consultants, Diabetes Specialist Nurses, Dieticians, and Podiatrists in clinics, whilst also researching evidence-based therapeutic approaches. I have also contacted and networked with other diabetes psychology services and created all sorts of documentation to ensure my service is a welcoming, safe place to attend.
Overall, my challenge is to always be the best that I can in all aspects of my role. I work part-time which of course means I have the added challenge of delivering as much as I can to as many people as possible within my working hours.
Being kinder to yourself
A number of things matter to me in my role as a psychologist caring for people who have a diabetes diagnosis. My main driver is that I understand the immense complexities of living with diabetes and that I can use my knowledge and skills to empathetically listen to people who want support and help them improve their quality of life by prioritising their self-care.
Our clients who attend our clinics are always my main concern. I want to help them be less self-critical and kinder to themselves as I know that they are doing the best they can at that moment in time regarding their diabetes management.
Working within the Southern Trust and therefore funded by the NHS, it also matters to me that I offer a well-informed, effective, and efficient service tailored to support as many people as possible who want support, all set within the context of good clinical governance.
For anyone attending our Diabetes Psychology Service, it’s vitally important that they know we genuinely care for their wellbeing. I would advise anyone accessing my service to be honest with themselves, less self-critical, and to always look for ways to be more self-compassionate.
A person living with diabetes has so many diabetes decisions to make in an average day, on top of all other life decisions. It’s completely understandable and normal to feel exhausted and overwhelmed by the relentlessness of this condition.
I also think that it is imperative that as healthcare professionals, we understand that perfection in diabetes management does not, and cannot, exist. Despite all our best efforts, we cannot do the complex, reactive job of a pancreas!
On a personal note: what advice would you give yourself if you were starting out now in your first job?
If I were to offer advice to a new Psychologist who was starting in our team, I would strongly encourage greater shadowing of multi-disciplinary clinics to develop a wider concept of all aspects of diabetes both from a patient and a healthcare professional perspective.
I would also encourage greater liaison with service user groups to identify and address psychology needs specific to people with a diagnosis of diabetes. I also feel that the Patient and Public Involvement (PPI) is so important; that aspect of co-production is invaluable in ensuring that Diabetes Psychology Service Interventions are fully informed by the lived experiences of service users, as well as by clinical research.
The views and opinions expressed in the ‘views’ section of this website belong solely to the authors of each article. These views and opinions do not necessarily represent those of Diabetes UK as a charity or any of its staff members.
If you are a healthcare professional based in Northern Ireland and would like to write for News & Views, please contact n.ireland@diabetes.org.uk with an outline of your idea.
