A VISIT TO THE PSYCHOLOGIST

 

This visit is integral to the operation.

If you have your own psychologist then I would need to have sight of his/her report.  6 weeks after seeing the psychologist you need to see myself and the anaesthetists.

The reason that there is a 6 week waiting period as that this is the time the psychologist needs to do a full assessment of all the tests you will be exposed to.  The psychological assessment is a very important part of the evaluation and a theatre date will not be given until we have the green light from the psychologist.  This is in line with the guidelines set for International Accreditation, which our team has, from the International Society of Obesity Surgery (ISOS).

 

The psychologists I use are:

 

Shannon Lang and Krishnie Pillay .
<<Their details are available here>>

 

This extract is from the Newsletter, compiled by Dr Brombacher in conjunction with Anlie Evetts, the dietician and Sarah van Niekerk, the Clinical Psychologist.

 

The Process of Change and the Role of the Psychologist

(Sarah van Niekerk, Clinical Psychologist)

 

Anyone who has ever made and broken a New Year's resolution (and yes, that includes all of us!) will be able to appreciate the real difficulty of behaviour change. Making a lasting, meaningful change in behaviour is rarely a simple process, and usually involves a substantial commitment of time, effort, sometimes money, and always emotion. People tend to progress through different stages on their way to successful change, with each of us progressing at our own rate, and making use of different means and support structures along the way. Researchers in the human and behavioural sciences maintain that the process of achieving one's goals and sustaining the gains made is perhaps best supported by an attitude of flexibility (well, this technique hasn't worked so let's try something else) and finding positive ways to stay motivated and focused.

"Readiness for change" is a dense concept with roots in personality structure and style; self-awareness and insight, self-concept, self-worth and attitudes towards self-care; motivation; one's profile of adjustment and adaptation; patterns of coping with stress; lifestyle factors; exposure to adequate knowledge and preparation; and the availability of support structures and a milieu of encouragement. Furthermore, stable and long-term change presupposes a process of decision-making that is internally-driven, as opposed to externally imposed.

When we consider that obesity places individuals at risk not just for associated physical and medical conditions, but also for a poorer quality of life and psychosocial complications (such as the risk for isolation, compromised self-esteem and depression), it becomes a physical and mental health imperative that we understand not only the mechanisms of behaviour change, but also those factors that may support and hamper the process of change towards general health and a sense of wellbeing. In relation to the bariatric procedures, it is also noteworthy that the same procedure may yield different outcomes in different patients, hence, highlighting that psychological factors (such as compliance, motivation and adjustment) contribute directly to the outcome of medical intervention and the ongoing management of obesity.

The most important elements in changing a behaviour, and which have relevance to the ongoing management of obesity, include the following:

Do I have the resources (including intra-personal and inter-personal, practical and lifestyle resources) and knowledge to successfully make a lasting change?

Is there anything preventing me from making this change?
(whether it be a personal or relationship factor)

What might trigger a return to a former maladaptive behaviour?
(whether it be stress trigger, lifestyle trigger, or relationship trigger)

 

The Role of the Psychologist

Both the mind and body are intricately involved during any process of change we undertake.

The pre-operative psychological/ behavioural health assessment has the goal of identifying both personal resources for coping and positive adaptation, as well as psychosocial risk factors, and to make recommendations aimed at facilitating the best possible outcome and adjustment for the person.

Typically, the person's behavioural style, cognitive/ emotional patterns, developmental history, current life situation and stressors, motivation, and expectations are explored.

The following areas are generally assessed and supported:

 

It is also important to consider that personal change is sometimes not met with the enthusiasm that we may expect from our loved ones and friends. Sometimes, change is met with ambivalence or resistance. It is for this reason that significant others are encouraged to participate in the process of change, and that their views and feelings are acknowledged. It is not uncommon for relationship issues to resurface during times of personal change, and also not uncommon for such issues to find gentle resolution with the correct support.

 

The process of change in regards to the management of obesity is best supported by the multi-disciplinary professional team, and a collaborative approach to understanding individual readiness for change, enhancing motivation, and developing avenues for social support and hope.

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