We passionately believe that sustainable recovery takes place in the client's home environment. All of the NICE guidelines' personal accounts talk of people going to various placements only to relapse when they return to home. Our interventions are aimed at people with significant levels of self harm and perceived high risk of suicide and prioritise doing things via negotiation and consent while avoiding coercion and control.
This package is based on the NICE recommended therapy DBT, and prioritises reducing potentially lethal behaviour, maintaining a therapeutic relationship and building a life worth living. Our intensive psychological containment model offers twice weekly sessions combined with 24 hour telephone support. We will help our clients to use the services around them effectively while providing the majority of their therapeutic contact.
Our team have experience of working effectively and informally in the community with those who it was felt that compulsory out of area therapy was the only option. In addition we have successfully transitioned people from secure units to the community where there were strong views that only compulsory detention could be provided. Our clinicians and Experts by Experience are keenly aware of the effects of iatrogenic harm - where what is done for the best results in maintaining/exacerbating problems, and we will work intensively with teams and clients to minimise these dynamics.
Where clients are unable to commit to DBT we offer a similarly intensive, goal focused intervention based around Structured Clinical Management. This is an approach with a comparable evidence base to DBT but without the requirement to give up self harm. We would work with clients to build a life worth living incorporating their views about their essential coping mechanisms. In the past our support has moved clients off wards where placement was considered the sole option, to over a year in the community receiving our support without admission.