Nephrology - The renal counselling and psychological support service

The renal counselling and psychological support service is part of the multi-professional team that offers help and support to adults (18+) who are experiencing emotional and psychological challenges related to their kidney disease. The service is provided by the renal counsellors. The service also supports renal staff to become more psychologically aware and trauma informed.

What is counselling?

Counselling involves a meeting between a counsellor and a patient, in a private and confidential setting, to explore a difficulty a patient is experiencing. The counsellor usually helps patients who are experiencing emotional or behavioural difficulties. These difficulties may be causing worry, distress, anxiety, depression, poor sleep, dissatisfaction with life, or a loss of a sense of direction or purpose.

What kind of help does a counsellor provide?

A counsellor will provide time and space to listen carefully to what is concerning you. By doing this they come to understand more fully the problems you are experiencing. They may be able to help you to see things more clearly, especially if you are feeling confused or overwhelmed.

A counsellor offers an opportunity to explore thoughts, feelings and concerns that are important to you. This may help you to gain insight, to make choices, or to adapt to, or accept things that can’t be changed. It may help you to feel less anxious or stressed, to feel stronger, and to feel that you have some control. The counsellor’s help may enable you to manage your health problem more effectively, and to enjoy life more. It may help you to learn additional skills and strategies for dealing with the stress of the changes and challenges that you may be facing.

What problems may be helped by counselling?

Kidney disease and treatments can sometimes be difficult to deal with. As a patient with kidney disease, you may have become familiar with some of the physical changes that this often brings to people’s lives. These can include fatigue, irritability and body image concerns. If you are on dialysis the dependency on a machine or the routine of peritoneal dialysis may be difficult to manage. Restrictions on food and fluids may be unwelcome. Considering a kidney transplant may bring particular concerns.

People ask for counselling help for a range of problems.

These include:

• Coming to terms with kidney failure
• Distress about the diagnosis
• Thinking through the various treatment options so that you can make the best decision for your particular personal circumstances
• Help in keeping to your treatment regime
• Coming to a really informed decision about living kidney donation, and talking through the emotional or relationship implications of it
• Difficulties in your relationship including sexual difficulties
• Anxiety
• Panic attacks
• Low mood
• Depression
• Fear
• Phobias ( needles, blood, medical procedures) that interfere with treatment
• Managing pain
• Managing sleep problems
• Managing difficult or uncomfortable feelings
• Coping with changes in your lifestyle

Where will I see the renal counsellor?

As an outpatient, having any form of dialysis treatment, a renal counsellor will see you in the counselling room at the Cambridge dialysis centre (CDC). If you are staying in the hospital a counsellor will try to meet with you in a private space. In cases where this is difficult, or you are feeling unable to leave your bed, a counsellor will meet you at your bedside, and try to make the meeting as private as possible.

The length of the meeting will be guided by your needs and wishes, but would not usually be more than an hour.

Will I have to wait for an appointment?

You may have to wait up to 6 weeks for an outpatient appointment, but if you are staying in hospital the counsellor will try to see you within a few days and arrange further appointments at mutually agreed times.

How long will I need to go on being seen?

Some people need just one or two meetings. Others may be offered weekly appointments for up to 12 weeks. Longer support may occasionally be needed.

What will happen to the information I share with the counsellor?

Anything you share with the counsellor will be treated as confidential information.

However, the counsellor works as part of a multi-professional team and at times it may be necessary to share some information with other colleagues. This will only happen:

• In order to improve the care you receive
• If there are special circumstances involving risk of harm

If the counsellor feels it is necessary to share any information about you this would be discussed with you first.

Contact details

Any patient with kidney failure may arrange to see a renal counsellor. The service is also available to family members.

You can contact one of the counsellors yourself, or you can ask any other medical professional involved in your care to refer you.

Renal Counsellors
Cambridge Dialysis Centre
Unit E
Beadle Industrial Estate
Ditton Walk
Cambridge
CB5 8PD

Telephone: 01223 400186

or Addenbrooke’s Hospital telephone 01223 274544.

Referral exclusion criteria

We do not accept referrals for:

• Active suicidal crisis
• Severe mental health disorders
• Substance or alcohol misuse
• Patients currently receiving psychological therapy elsewhere

Additional considerations

• Patients with complex trauma or enduring mental health problems may need specialist, longer-term psychological treatment in the community. We can help signpost for onward referral. This will be determined on a case-by-case basis.
• We work closely with the Renal Social Worker and will signpost patients appropriately when social care is needed.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches) and a current repeat prescription from your GP

Please tell the ward staff about all of the medicines you use. During your stay If you wish to take your medication yourself (self-medicate) please speak with your nurse. Pharmacists visit the wards regularly and can help with any medicine queries.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website: MyChart

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.