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Children's Clinical Psychology
We provide assessment and psychological help to young people aged 0 — 16 and their families/carers.
A young person will usually be referred to Clinical Psychology because they, or someone else, is concerned about their emotional well-being, their development or their behaviour.
A short video guide on how to get to the Children's Clinical Psychology department.
Simon Lalonde Head of Service Telephone: 01332 785 542 Email: simonlalonde@nhs.net
What will happen at your first appointment?
The first time you come to see us, your appointment will usually last about 1 hour 30 minutes (unless it says something else on the letter we send you).
The person who referred you will have told us some information about you and the reasons why they've asked us to see you.
In your first appointment, the psychologist will ask questions to find out more about the difficulties/concerns you are having.
These questions may be about how things are at home, at school or within your family. You and the psychologist will talk together about what the difficulties are and about how we might be able to help.
On this first visit we often speak to you and your parents/carers separately.
From 1 April 2022 referrals for children and young people with tics or Tourette’s syndrome will no longer be accepted by the Department of Clinical Psychology.
On this page there are resources about tics and Tourette’s for children, young people and their parents and for schools. There is an advice sheet for talking to young children about tics and examples of stories that may be helpful to further explain and reassure young children about tics/Tourette’s. There are also informational videos for children and young people and for parents of children with tics covering information about what tics are and about living with and coping with tics/Tourette’s syndrome.
Referral process for children and young people with Tics/Tourette’s syndrome
Information for Derby City and Derbyshire from 1 April 2022
If tics are associated with symptoms of mild to moderate anxiety or low mood or difficulties with bullying, children and young people and their families can self-refer to the Build Sound Minds or Compass Changing Lives services:
Children and young people with mental health difficulties meeting CAMHS criteria e.g. OCD or significant anxiety/low mood should be referred to CAMH services via the Single point of Access (SPOA). Referrals to SPOA can only be completed by GPs and primary care professionals in health, education and local government.
If there is also a concern about possible ASD/ADHD in conjunction with tic symptoms, referrals for a possible Autism or ADHD diagnosis should be referred to the Neurodevelopmental Pathway for assessment. Referrals to the Neurodevelopmental Pathway can only be completed by GPs and primary care professionals in health, education and local government. More information on the Neurodevelopmental Pathway:
Some young people in your school have Tics. Tics have a neurological cause. A Tic can be a small or a large involuntary movement, speech or other vocal noises that are repetitive. The individual experiences a compulsion to Tic, like a mounting pressure which then ‘explodes’ as a Tic or collection of Tics.
You may have noticed some of their Tics, but they can also lead to other difficulties in class too, the severity of which tend to increase throughout secondary school.
What young people with Tics really want other people to understand…
It’s unpredictable - Tics change, new ones come, old ones go, they don’t choose them. This is very stressful for the young person and presents ongoing challenges to those around them. One Tic might last for months and then disappear or return later, another might change during the course of a day.
It’s uncontrollable - Sometimes a Tic can be held in for a while, maybe only a few seconds, but it’s hard to do and then it explodes out anyway. Imagine you have an overwhelming need to cough but you are in a place where it is absolutely imperative that you remain silent. You would use all of your available concentration to try and stop your body doing what it needs to do – you’d be exhausted – this is what young people with Tics experience much of the time, and as you can imagine it leaves little space for concentrating on the lesson in hand.
It’s involuntary – While Tics change and the urge to do them can get better or worse, young people often feel that they are always present. Sometimes the concentration involved in not doing their Tics can be immense, but when focussed on something else, a young person could be doing their Tics without even knowing it.
It really gets in the way! – Doing Tics or trying not to do them takes a huge amount of focus and energy; this makes it very difficult to concentrate in school and can make a young person so frustrated that they can snap very easily. Other people can think that the young person is choosing to misbehave or not put effort in, when in reality they are trying very hard, but Tics are taking up most of their energy.
It’s embarrassing – having Tics can really make you stand out in a classroom, this can make social relationships very difficult and can make the young person a target for bullying.
What you can do to help
As everyone with Tics is different, and because it can change so much, it’s useful to have a range of ideas that can help with;
managing anxiety / building self esteem
concentration in class
dealing with frustration & developing appropriate responses
relevant school staff not only knowing about the young person’s diagnosis, but having a good understanding of the effects of Tics, and how they can help.
Remember
Having Tics is not an excuse for bad behaviour or breaking the school rules, but it is a reason for not concentrating and not listening at times. It can have a profound effect on a young person’s self confidence, self esteem and mood.
Lastly
Disclosure about having Tics is a very personal thing. Some young people with Tics will want their peers to be aware of this and will benefit from school’s support to do this. However, many young people will prefer that this is kept confidential from their peers.
The complex behaviour service is a specialist mental health service for children with learning disabilities.
The service provides intensive support in the family home to facilitate behavioural change. Staff work closely with the child’s existing professional networks, and can also provide consultation about children not directly referred to the service.
The team consists of clinical psychologists and specialist learning disability nurses. This is a small team, and referrals will only be accepted if the child and family have already received significant support and advice from specialist professionals.
Referrals can be made by paediatricians, child and adolescent psychiatrists, clinical psychologists and community learning disability nurses.
Information for referrers
Ours is a specialist service which accepts referrals from GPs, hospital and community consultants, social care (only when the family has an allocated social worker), child and adolescent mental health services and psychiatrists, educational psychologists and clinical psychologists.
When you refer to child clinical psychology we need the following information:
Name
Date of birth
Address
GP
School and details of other professionals or services involved with the family.
In addition to the reason for referral, any significant family history would be helpful.
The referral must be in writing. We do not accept telephone or email referrals.
All new referrals are discussed at a weekly meeting by senior members of the department.
Every referral will be acknowledged by letter.
You will receive a copy of the first appointment letter and regular updates of progress until discharge.
