The Complex Care Clinic (WKH: CCC) is here to care for children through to young adults who have complex medical conditions.
Our care may involve one or more of our therapists working towards your child’s specific goals. Our focus is to provide an evidence-based wrap-around service that provides expertise from multiple disciplines. Working collaboratively, we help our patients live their best lives.
Conditions we can help with
WKH:CCC have worked extensively with the following conditions:
- Chronic pain
- Complex regional pain syndrome
- Chronic widespread pain syndrome
- Juvenile arthritis
- Functional neurological disorder
- Chronic fatigue syndrome
- Post-concussion syndrome
- Ehlers Danlos syndrome/Hypermobility Spectrum Disorder
- Postural orthostatic tachycardia syndrome
- Persistent headaches
- Chronic recurrent multifocal osteomyelitis (CRMO)
- Long COVID
- Rare genetic conditions – achondroplasia, osteogenesis imperfecta
Our physiotherapy team helps to improve your child’s physical function and capacity. Our physiotherapists utilises psychologically informed physiotherapy care to complement the therapy provided by other disciplines, such as psychology.
Our psychology team aids in coping with the symptoms associated with these chronic conditions and changing unhelpful beliefs that may impede recovery. Our psychologists can also help with comorbid conditions, such as anxiety and depression, that are commonly associated with complex chronic health conditions.
Our dietetics team provide guidance on how anti-inflammatory diets can be a part of symptom management and individualising these protocols to food preferences and your family eating style. They can assist with optimising eating patterns to improve energy levels, ensure adequate intake of nutrients and support normal growth patterns. Our dietitians can also provide guidance around elimination diets/ reintroduction of foods to manage gastrointestinal issues (constipation, diarrhoea, bloating, etc.) that are common with hypermobility spectrum disorder/Ehlers Danlos syndrome.
Our occupational therapy team assists your child to minimise the impact symptoms may have on sleep, school and relationships. Additional supports include:
- SCSA Assessments
- Social skills
- Handwriting skills
- Academic Stress Group or 1:1
Group Programs
- Holiday program – 6 sessions over 2 weeks (M/W/F)
- Term program – 8 sessions over 8 seeks
- Parents of children/adolescents with persistent pain – weekly for 5-6 weeks
- Parents of children/adolescents with functional neurological disorders – weekly for 5-6 weeks
- Weekly group session over 8 weeks
- Holiday program – 6 sessions over 2 weeks (M/W/F)
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4 sessions weekly
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4 parent sessions
Online Programs
POP Program
For children or young people who are significantly impacted by pain, fatigue, or other symptoms we offer a tailored POP Program. Guided by evidence, we recognise the importance of our unique approach in that the experts in our clinic work collaboratively to achieve your desired goals.
The POP Program starts with an intake, which is usually 2 hours, where you will meet three experts from your team who will assess your needs. Our goal is to ensure you only tell us your story once and to make sure you are understood and have input into your treatment planning. At the end of your intake, we sit down and make a treatment plan with you. This will sometimes mean expert clinicians from Psychology, Occupational Therapy and Physiotherapy will be required, or only one of those. Each treatment approach is bespoke based on the evidence for treatment and your needs. Once you start with us, one of the clinicians assigned to you will be your treatment-lead and they are available to contact to talk about any further needs or issues.
While we work one-on-one with our patients, we also provide online modules to help parents and partners understand the conditions and what is going to happen in treatment. The online modules will also help parents, caregivers and/or partners understand how important their understanding of the condition is and how they can help us maximise the benefits of our therapy.
Evidence for Approach
For many chronic conditions, the evidence is clear that a multi-disciplinary team is required. For example, the evidence for the treatment of many chronic pain conditions is strongest for exercise and psychotherapy as part of a multidisciplinary team (treatment guidelines link)
For conditions like Functional Neurological Disorder, the evidence has again led most organisations representing FND communities to recommend that multidisciplinary approaches are taken; Guidelines, Research. In some cases, the evidence is emerging for specific treatments for specific issues (like CBT for functional seizures: research) and our clinicians use this evidence-based to tailor treatment to the needs of each individual.
The role of dietetics in supporting clients with complex conditions is well recognised. Organisation such as IASP (International Association for the Study of Pain) and ACI (Agency for Clinical Innovation) include nutrition support as part of their recommendations for chronic pain management. There is also growing evidence that optimising dietary patterns can help improving symptoms of juvenile arthritis; research and mental health conditions; research in children.
Exercise in JIA populations is well tolerated and provides benefits including:
- Improved bone density, functional capacity and muscle strength (Kuntze et al., 2018)
- Reduced pain, improved range of motion and quality of life (QoL) (Bhende, Shinde & Shinde, 2022; Iverson et al., 2022).
Exercise in HSD/hEDS population showed:
- Reduced pain reports, improved proprioception, improve QoL (Engelbert et al., 2017; Reychler et al., 2021).
- A physiotherapist prescribed, supervised, individualised and progressed exercise programme effectively reduces knee pain (Pacey et al., 2013)
Physical therapy is beneficial for children with persistent pain in a gym environment to resume to normal function (Clinch & Eccleston, 2009)
Our Complex Care Team
We have been fortunate to build a team of dedicated physiotherapists, occupational therapists and clinical psychologists who are keen to keep learning and to work closely together.
Our staff includes senior clinicians with experience working with complex conditions in hospitals with chronic pain services, neurology services, and rehabilitation services. We work closely together to bring you the best treatments, which also means we regularly reviewing the needs of our patients at multidisciplinary team meetings and checking how treatment is progressing.
Our team also strives to use the most recent research to guide our work. An outcome of this is our team is currently part of two major research projects into the predictors of chronic pain treatment outcomes and designing evidence-based treatments for lower limb pain.
NDIS Services
If your child has NDIS funding you can apply for our evidence based intensive programs below via our NDIS enquiry link.
All NDIS intensives will be preceded by an intake appointment with one or more of our team.
We recognise that life-long conditions (including but not limited to autism spectrum disorder, cerebral palsy, spinal cord injuries, brain injuries) can impact children and young people physically, socially and psychologically. These issues can cause or contribute to the development of persistent pain and functional issues (functional movement disorders or functional seizures).
We offer a multidisciplinary team or single discipline intensive block that treats or manages pain or functional issues while addressing relevant NDIS goals . This block involves a rehabilitation approach including education, development of active management strategies, parent or caregiver coaching and an individualised treatment plan. Following the treatment block, our team will provide your primary provider team with a handover for future management.
A 6-week program for teens with inflammatory conditions or connective tissue disorders wanting to participate in yoga.
Our Mental Health OT Tiffany combine her yoga training with her extensive knowledge in JIA, HSD and hEDS to create a safe yoga program that includes physical strengthening, mindfulness and relaxation.
This intensive one to one program is led by our clinical psychologists and aims to build your child’s skills and tools to manage living with a chronic condition and the associated symptoms (pain, fatigue etc).
This intensive block can be between 8-20 sessions dependent on goals and needs.
A 6-8 week physiotherapy led strength & conditioning program for children and teens with complex conditions such as JIA, OI, hEDS, FND, CRPS, chronic fatigue, POTS etc
This program aims to improve function and is goal oriented.
TARGiT
- Holiday program – 6 sessions over 2 weeks (M/W/F)
- Term program – 8 sessions over 8 seeks
Parent Groups
- Parents of children/adolescents with persistent pain – weekly 5-6 weeks
- Parents of children/adolescents with functional neurological disorders – weekly 5-6 weeks
Recondition Program – (POTS/EDS/Post-COVID group)
- Weekly group session over 8 weeks
- Holiday program – 6 sessions over 2 weeks (M/W/F)
SUP (FND Group) “Software Update Program”
- 4 sessions weekly
- 4 parent sessions
