Below are the services we offer.
The Acute Therapy Service (ATS) offers a 6 day intensive support programme in the community. This service supports people aged 16+ during a mental health crisis by providing an alternative to hospital admission and/or facilitating early discharge from hospital.
The ATS is a psychologically led programme and is based upon the Dialectical Behaviour Therapy (DBT) model; DBT principles underpin all aspects of the programme service. In the 12 months following the start of the Pilot, ATS was found to prevent further admissions in around 85% of service users who used it.
Our service is a place where you can engage with specific psychological interventions that will help you to manage your emotions. We will provide you with a safe and friendly environment with positive and supportive staff. We will teach you about your emotions, because the research indicates that being able to understand our emotions helps us to be more able to regulate them. We will support you and teach you skills to help regulate your emotions during times of distress to help you get through these difficult times.
We will also introduce you to:
- Wellbeing and healthy living advice
- Social inclusion and activities in the local area
- Holistic therapies
We provide breakfast, lunch and refreshments throughout the day. You are able to approach staff for 1:1 support as required between the group sessions.
The groups we teach include:
- Emotion regulation
- Crisis skills
- Social skills
- Problem solving
- Occupational therapy
- Sleep hygiene techniques
We have various in house activities you can do to promote recovery, such as arts and crafts, relaxation, games and we have a quiet room you can use if you need time to yourself.
We encourage you to become more independent and therefore live a more fulfilling lifestyle.
I preferred my wife to be at ATS rather than in hospital. It meant she could be home with me each evening and she taught me the skills she had learnt. This enabled me to help her better when she went into a crisis and I felt I was contributing towards her recovery.
The Referral Process
If you are likely to be admitted to hospital, you can request that you attend ATS instead. Similarly, if you are already in hospital you could request that you attend ATS as a means of being discharged from hospital sooner. Your care team can refer you to us by telephone. The ATS team will consider if the service is able to support you at this time and, if appropriate, make arrangements for you to start. You will be telephoned by a member of the ATS team in the 2 working days before you start so to give you the opportunity to ask questions and for the team to explain what you need to know about the service prior to starting.
What is Dialectical Behaviour Therapy (DBT)?
DBT is offered across Lancashire by the Personality Disorders Managed Clinical Network (PDMCN).
DBT is a type of talking therapy aimed at helping people to learn how to achieve behavioural stability – that is, to replace impulsive, risky or somehow damaging ways of coping with less harmful and more skilful ones ones.
It is usually aimed at treating people who engage in life threatening behaviours (self harm; suicidal thoughts and behaviours) and those who experience their emotions very intensely. The aim being to help a person to develop a life worth living.
DBT has four elements:
- Individual Therapy: this consists of weekly sessions with an individual therapist. Working towards goals to help achieve a life worth living. You will be required to complete weekly diary cards to monitor problem behaviours, emotions and urges. This information helps to decide what you will work on in each session.
- Skills Training: this consists of weekly teaching sessions that cover four modules and the group is run like a class where the leader teaches skills. The behavioural skills taught are; Mindfulness; Interpersonal Effectiveness; Emotion Regulation and Distress Tolerance and involves weekly homework and skills practice.
- Telephone Coaching: This is offered by individual therapists and involves offering structured support to help teach people to use their new skills in real life situations. It is focused on providing people with in the moment coaching on how to cope effectively between sessions.
- Therapist Consultation Team: DBT therapists work in teams and meet weekly for supervision. The consult team is designed to help therapists discuss issues and concerns, help them to treat people more effectively, stay motivated and competent and share responsibility.
The Life Skills Course is for people who are currently being supported by Community Mental Health Teams.
The Life Skills Course is a Psycho-education course (understanding, knowledge and practical skills) and is for people who can have difficulty regulating emotions, have difficulty with relationships and can have difficulty with day to day problem solving.
There are different modules that run on a rolling basis; these are focused on the following topics:
- Tolerating distress
- Tolerance of Emotions
- Sensitivity and Interpersonal Problems
- Impulse Control
Modules run for six weeks and last around 90 minutes. These sessions will consist of a combination of skills teaching and group problem solving.
There is a requirement that group members will attend all six sessions of the module. Some people may attend just one module, others may go on to complete several or all of the modules.
If you are interested please discuss this with your care coordinator.
What is Structured Clinical Management (SCM)?
Structured Clinical Management (SCM) is an evidence-based intervention for people who have symptoms consistent with Emotionally Unstable Personality Disorder (EUPD).
Emotionally Unstable Personality Disorder is a diagnostic term used in mental health services. It acknowledges that for some people aspects of their personality can significantly restrict their quality of life.
Although EUPD is associated with enduring difficulties, with the right help and support we now know that most people with this diagnosis can get better.
Is SCM right for me?
SCM may be right for you if you have difficulties around:
- Impulsivity (acting without thinking)
- Managing relationships
- Problem solving
- Managing emotions
- Meet criteria for a diagnosis of emotionally unstable personality disorder (may have other diagnoses as well)
- Would like a life outside of mental health services
What help can I expect?
SCM involves three phases; an introductory phase involving work with an individual SCM practitioner, an intervention phase which involves individual and group work and an ending phase with your individual practitioner.
Initially, your SCM practitioner will work with you to go through:
- Your diagnosis
- Develop a crisis plan
- Help you identify problem areas
- Help you define your goals (short and long term)
- Advocate for you
In the intervention phase they work with you to help you develop knowledge and skills to meet your goals by focusing upon:
- Problem solving
- Understanding and managing strong emotions
- Understanding others and managing relationships
SCM involves weekly forty five minute individual appointments that will usually take place on an outpatient basis. The appointment will focus on the current difficulties you are having.
The evidence suggests that groupwork is crucial to giving you the best chance of improvement. Your SCM practitioner can work with you to help you attend the group component of the intervention. The group occurs weekly lasting one hour thirty minutes. It focuses on here and now problems and goals including themes in the areas of difficulty referred to previously.
At the moment there is no medication that is proven to treat emotionally unstable personality disorder. You may be offered medication for other related problems.
What is the commitment for?
You will be in the SCM intervention programme for up to 100 weeks. There is also an ending phase following completion of SCM.
In SCM you are required to complete brief questionnaires; this helps you and us monitor progress.
What about hospital treatment?
The most effective treatment for EUPD occurs in the community.
If hospitalisation is required it is recommended that the admissions are short and are focused on a clear goal. For example, an admission may be for assessment (to try and understand what could be causing the current difficulties). Or it may be to help stabilise an acute crisis, for example, by establishing or revisiting a crisis plan or a community care plan.