It’s not all in the mind: How psychology can help people affected by physical health conditions
It’s not all in the mind: How psychology can help people affected by physical health conditions
Physical health conditions, illness and injury have a psychological impact that’s often ignored. Perhaps one of your medical team has noticed that you are distressed and suggested that seeing a psychologist might help. You might be struggling with the emotional or social impact of an illness or injury. Loved ones, family or friends might be worried about your understandable distress or you might want to talk to someone outside your circle of loved ones.
Those are just some of the reasons why talking to a psychologist who specialises in the psychological impact of physical health conditions – a Clinical Health Psychologist - might help. If you've ever wondered what a psychologist does, what kind of training they have, and how they can help, you're not alone. Many people feel uncertain about seeking psychological support, often unsure of what to expect or how therapy could benefit them. In the face of a life-changing or life-challenging illness or injury, it’s hardly surprising that many people experience difficulties with their psychological well-being. Whether you're facing personal challenges, struggling with your mental health, or simply looking to understand more about psychological therapy, this guide will provide insight into the world of clinical health psychology and what you can expect from working with a professional.
What is a Clinical Health Psychologist?
In the UK, there are a number of legally protected titles psychologists can use if they have completed appropriate training and continue to meet the standards of the Health and Care Professions Council (HCPC) to remain registered with them. These requirements include ongoing professional training, appropriate insurance and supervision. These titles come under the general one of “Practitioner Psychologist” and include Counselling Psychologist, Clinical Psychologist, Educational Psychologist and a few more. Clinical and Counselling Psychologists focus on providing psychological assessment and treatment for mental health issues and emotional distress. Clinical Health Psychologist is not a legal or protected term but it is used to indicate that a psychologist has an interest and experience in providing psychological support in the face of physical health issues. Think of it this way: technically, anyone could call themselves a Clinical Health Psychologist but you need to be registered with HCPC to use titles like Counselling Psychologist. For this blog, I’m going to use the term Practitioner Psychologist to refer to a psychologist registered with HCPC and Clinical Health Psychologist (CHP) to mean a psychologist registered with HCPC with training and experience in providing psychological support to people with a physical health condition.
What does that mean if you’re looking for psychological support?
Finding a psychologist, therapist or counsellor you can work with is a very personal act. Not every psychologist will be a good fit for every client even if the client’s experience is a good fit to that psychologist’s experience and interests. There’s more about this in my blog [https://oaktreepsychology.com/blog-post1]. If you meet a CHP you don’t feel comfortable with, it simply means the two of you aren’t a good fit. It certainly doesn’t mean you’re “too fussy” or the psychologist isn’t good at their job. It does mean that neither of you is likely to get much out of working together.
Practitioner Psychologists are highly trained mental health professionals who specialise in understanding, diagnosing, and treating emotional and behavioural difficulties. Unlike psychiatrists, who are medical doctors and can prescribe medication, they focus on therapy-based interventions to help individuals manage and overcome challenges such as anxiety, depression, trauma, and stress-related conditions. Their work is grounded in evidence-based approaches designed to support people in developing coping skills, improving emotional well-being, and achieving a better quality of life.
CHPs work with people of all ages—from children and adolescents to adults and older adults — who are experiencing psychological distress related to a physical health condition. In the face of health challenges, there can be a complex mix of physical symptoms, medication side effects and psychological impact to navigate. Those “not a physical symptom” issues are where an appropriate psychologist might help.
What can a Clinical Health Psychologist help with?
Just as you wouldn’t expect a dermatologist to treat your complex broken leg (I’d want an orthopaedic surgeon for that!), CHPs often specialise in a fairly narrow range of health conditions. Most CHPs can also, however, offer general support in the face of most health conditions in the same way your GP can support you while you work with either a dermatologist or surgeon. When you’re looking for support, this is one of the first questions to ask.
CHPs use techniques very similar to those used to treat mental health issues such as anxiety, trauma and low mood to support people who are anxious or distressed due to the impact of physical health issues. Think of it this way: if a medication you genuinely need causes nausea, your medical team will almost certainly prescribe medication to treat the nausea. If a physical health condition creates psychological symptoms, why would you not use psychological approaches to help with that?
The psychological impact of life-challenging or life-threatening conditions can include distress, anger, low mood and other types of distress. It can interfere with sleep, activities you enjoy, relationships with loved ones, family and friends and reduce your quality of life. While it’s true that psychology can’t “fix” physical problems it can support you to live the best life possible in the face of them.
CHPs might help with:
· Coping with the anxiety of a diagnosis
· Being the person who hears the things you can’t tell loved ones (yes, we will talk about being afraid to die, the possibility that your children might have to grow up without you and other topics like that). We won’t ever force you to have those conversations if it’s not right for you though. The furthest we will generally go is to ask if you would like to talk about that.
· Preparing to talk to loved ones.
· How to engage with your medical team.
· Feeling low because of physical symptoms.
· Supporting you to follow the best advice of your medical team (did you know that it’s actually very common for cardiology patients and diabetics to struggle with treatment plans because of anxiety related to their condition? CHPs can be very helpful there). This can also support you to follow “pacing” plans if you have CFS/ME.
· Managing feelings such as anger or shame related to either a health condition or feeling that you can’t manage it well.
· Adjusting to life changes caused by health conditions.
For me, I think that being the person who can hear the very worst fears you might have when you don’t want to hurt loved ones by saying them out loud is one of the most important aspects of clinical health psychology. If I can provide a safe space where I can stand beside someone at one of the worst moments they might ever experience and help them feel heard, I feel privileged to do so. And the research tells us that that alone can help alleviate distress.
CHPs most often work on a one-to-one basis but they can also work with groups, couples and families. In essence, whatever is most likely to help you manage your challenges.
What Training Does a Clinical Health Psychologist Have
Becoming a practitioner psychologist is a long and demanding journey that involves years of academic study and practical training. In the UK, the path typically begins with an undergraduate degree in psychology, which provides a strong foundation in understanding human behaviour, emotions, and thought processes. This degree must be accredited by the British Psychological Society (BPS), ensuring that graduates meet the necessary academic standards to pursue further training.
Following their undergraduate studies, aspiring clinical psychologists gain practical experience working in mental health settings, such as hospitals, schools, or community clinics. This hands-on experience is crucial for developing an understanding of how psychological theories apply in real-world scenarios and for building essential skills in assessment, diagnosis, and treatment.
The next step is completing a Doctorate in Clinical Psychology (DClinPsy) or Counselling Psychology (DPsych), a rigorous three-year program that combines academic coursework with extensive clinical placements. Trainees work across a variety of settings, treating individuals with diverse mental health needs. Throughout this period, they learn and apply different therapeutic approaches, such as:
Cognitive Behavioral Therapy (CBT): Helps individuals identify and change unhelpful thought patterns and behaviours.
Psychodynamic Therapy: Explores unconscious thoughts and past experiences that may influence current behaviour.
Systemic Therapy: Focuses on relationships and family dynamics to address mental health challenges.
Mindfulness-Based Approaches: Encourages awareness of thoughts and emotions to improve emotional regulation and well-being.
Once they have successfully completed their training, clinical psychologists must register with the Health and Care Professions Council (HCPC) in the UK, which ensures they adhere to professional and ethical standards. Many also pursue additional qualifications or areas of specialization, such as working with trauma survivors, neurodivergent individuals, or those in high-stress professions like aviation. CHPs will often train and work alongside medical teams to gain experience in working with health conditions.
Therapy Sessions:
Therapy is not a one-size-fits-all process; it is tailored to your unique needs and circumstances. Sessions are usually conversation-based and structured to provide guidance and insight into your concerns. Some individuals find relief within a few sessions, while others may require longer-term support, depending on the complexity of their challenges.
Sessions are sometimes called “the tip of the iceberg” because most people find that change comes away from therapy, either once they’ve had time to reflect on a meaningful conversation with their psychologist or they’ve practised skills taught in the session. In fact, the immediate reaction to finishing a session is often “I’m exhausted now”! If that’s you, please know that is fairly typical and be gentle with yourself while you process the session.
Therapy can happen in person or online. If you have mobility issues or struggle with fatigue or travel, the good news is that modern research demonstrates that online therapy is just as effective as face to face.
Common Concerns:
Many people worry about whether therapy will work for them or if they’ll feel judged. Practitioner psychologists create a non-judgmental space where you can explore your thoughts and feelings openly. Therapy is a collaborative process, meaning that your active participation and willingness to explore new ways of thinking and behaving are key to making meaningful progress.
Making the Decision to Seek Help
If you're considering therapy, it’s important to find a psychologist who feels like the right fit for you. Remember, mental health is just as important as physical health, and reaching out for support is a sign of strength—not weakness. In clinical health psychology, we’re working where the two overlap. If your medical team have suggested that a psychologist might help, it’s not because they think it’s “all in your mind” or that you’re weak or should be coping better. It’s because they have noticed that you might be distressed for very good reasons and they want to ensure you have the right support. Prompts from family and friends might have been clumsy (“you’re not coping – get some help”) but they’re almost certainly well-meaning and might be worth paying attention too. With the right support and strategies in place, it is possible to achieve a greater sense of balance, well-being, and fulfillment in life.
A sidenote on managing family and friends
One of the most common conversations I have as a Clinical Health Psychologist is about the impact becoming ill has had on the way in which people behave around you. It’s incredibly common for caring people who find out that someone has a significant health issue to want to wrap them in cotton wool for protection. It’s very well-meaning but it’s often really not helpful! Unfortunately, it’s also very common for people to start avoiding you in this situation because they don’t know how to talk to you. In both situations, it’s absolutely OK to decide these aren’t people you want to be around at the moment. That’s not a great solution for many people so an alternative is to “teach” people how they can help and how to behave around you. Here are some tips:
Responding to people who want to protect you is a tricky one: it’s motivated by love and care but it often goes too far. Some things that might help:
· “I really appreciate the offer of help, but it’s important to me to do as much as I can for myself. I’m making coffee, would you like one?”
· If that doesn’t work, feel free to “quote” your medical team or psychologist: “my nurse told me to keep as active as possible to support my recovery. I can’t lift the kettle at the moment but I can carry my own mug of tea to the table and we can have a chat about the garden”.
· “I know you’re worried, but I’ve told you everything (that I want you to know) for now, can we go out for a walk and talk about something else”?
· “What would be really great is if you could be the friend/ loved one who isn’t all about my health. Could we check in about that once a day / week and then do what we usually do – I really love talking about that trashy TV programme with you.”
· “I know you’re worried, I’d like to know how you are too, let’s talk for half an hour and then get on with the day”.
· “The fact that I’m ill doesn’t mean you can’t tell me about your worries. It helps to know I’m not being wrapped in cotton wool too much!”
There’s often not much you can teach people who start avoiding you. It can sometimes help to remember that it’s frequently because they’re scared of being intrusive or of hearing difficult information or nervous about hearing details of physical health issues. If you’d like to stay in touch with them, “Even though I’m ill, I’d still like to go the garden centre with you – we don’t have to talk about my health, I’d love your advice on which roses to plan” can sometimes help.