Diabetes Care for You (DCFY) is a multi-disciplinary service commissioned by two Clinical Commissioning Groups (CCGs) covering East Sussex within Sussex Community NHS Foundation Trust. It was commissioned in 2016 and has recently been recommissioned. The approach to diabetes management is to have psychotherapy embedded within all patient care pathways, from insulin pumps to Type 1 and Type 2 education.
Within the service, there are two Cognitive Analytical Therapists and one Psychological Wellbeing Practitioner, though DCFY is a non-IAPT service. The Lead Psychotherapist, Jackie Fosbury, has worked in diabetes for over 28 years. All staff from podiatrists, to dietitians, and nurses complete psychological wellbeing screening at each appointment. The psychotherapy team will see patients with depression, anxiety, diabetes distress or burn out, and eating disorders such as diabulimia (which may affect those with Type 1 diabetes) and binge eating disorder. Therapy is dose-adjusted according to patient diagnosis and distress.
On average people are seen for 4-16 sessions of weekly therapy. Pre and post therapy psychological measures are used as well as biochemical measures, such as measuring the amount of blood sugar levels. Patients are not sent out of the diabetes service into psychological services, but are seen by the psychotherapists within the physical health clinic. The psychotherapy team also regularly psychologically upskill members of the diabetes multidisciplinary team as the service believes that psychological care is everyone’s business.
DCFY was presented as an example of best practice in this report published by Diabetes UK. Jackie Fosbury was recently asked to present to the All-Party Parliamentary Group for Diabetes on integrating psychotherapy into diabetes care. She was also interviewed by the UK Council for Psychotherapy (UKCP) with Dan Howarth (Head of Care at Diabetes UK) on how the DCFY service works and what their outcomes are. A podcast of this interview is now available through Diabetes UK and the UKCP.
Diabetes Psychotherapy Lead