What does working with us look like?

 
 

 

Who are Beam?  

 

Beam is an organisation made up of people with both occupational and lived experience of the mental health system. We founded Beam after years of working within the NHS, seeing people with complex trauma, neurodivergence and physical health problems be misunderstood and seen through a lens of ‘personality disorder’. We saw that this way of understanding people’s difficulties meant they were generally treated worse than their peers, were frequently sent to restrictive environments that had no evidence base for their care or treatment and saw people often returning from placements worse than when they left. We wanted to create a service that helps people transition back to their local communities or avoids prolonged hospital treatment altogether, providing interventions in-line with NICE guidance. We aren’t ’anti hospital’, we’re anti-harm and we frequently see prolonged admissions being re/traumatising. Treatment can’t help if it causes more problems than it solves.  

 

Keir is an Occupational Therapist by background, is also trained in DBT and SCM and has an MSc in ‘Personality Disorder’ (although he doesn’t think too much of the construct). Keir worked in the NHS for over 20 years in mental health and worked for a number of specialist services for those with a diagnosis of ‘personality disorder’, these included DBT services and Therapeutic Communities which shaped the way he works with people with a conscious effort to ensure those we work with hold power and autonomy for themselves.  

 

Hollie is a Consultant Lived Experience Practitioner and Integrative Counsellor. Hollie has lived experience of the mental health system, both inpatient and community care and a range of therapeutic interventions. Hollie has also worked within the NHS and Criminal Justice and has delivered training on ‘personality disorder’ nationally. She is also a trained Peer Support Worker and Hearing Voices Network Facilitator. Hollie has a BSc in Psychology and Counselling, she decided to train as a therapist after receiving a lot of interventions delivered by people she wouldn’t trust to look after a hamster and thought if they could do it, she must have a half decent chance of hopefully being less useless.  

 

We’re both members of the executive committee of the  British and Irish Group for the Study of Personality Disorder as well as the Royal College of Psychiatrists Expert Reference Group for Personality Disorder (where we spend most of our time trying to get people to avoid using this way to describe peoples difficulties) We’ve written some papers and done lots of talks about the work we do, the way we think ‘personality disorder’ is a rubbish way of describing people, and how we see people be harmed as a result.  

 

We want to be real people to people. We don’t tend to hide behind ‘professionalism’ or think we know everything, which means we’re sometimes a bit cheeky, a bit sweary and we’ll tell you that we don’t know, rather than lie to you. We really encourage those we work with to be real people too. 

 

What are we here to do?  

 

We help the people we work with to make sense of the things they do, why it is understandable in relation to the things they’ve lived through and how they make sense of themselves, other people and the world around them. We do this by spending time together to create a formulation. A formulation is a document that helps to break down what goes on for you and why. The formulation we create together then goes on to inform your care and the systems around you. We help others involved in your care to understand your difficulties in the most empathic way possible and work with you in a way that best suits your needs. We find that when organisations and teams can truly understand why people do what they do, keeping them in environments where they have little power and lots of restriction and restraint become the problem rather than the solutions they were previously. This normally means we help teams to genuinely listen to the people they are trying to help.  

 

What does our assessment process look like?  

Our assessment process is over around 6 weeks where we’ll spend 1 - 1.5 hours at a time together but it’s down to what you feel is tolerable.  

 

Some people feel that this is really long… and it is… but there’s a few reasons why we like to spend 6 weeks together:  

 

  • We’re strangers and you understandably might find it hard to trust us. 

  • We’re not just doing ‘an assessment’, we’re hopefully building a relationship and getting to know each other.  

  • We spend a long time asking about things in detail, sometimes in detail people have never been asked to think about before. 

  • People will send us lots of reports about you; the difficulty is they’re often not very accurate. We’d much rather ensure we’re getting the right detail in a way that means something to you, not just what someone might have decided after 20 minutes of meeting you.  

 

During our time together we’ll think about the following:  

 

  • Your early life  

  • Your relationships 

  • How you see and understand yourself 

  • The function of the things you do and why they make sense  

  • Why help hasn’t been helpful  

  • What’s led you to where you are now and why you’ve been referred to us  

  • What help might look like  

 

 

What we’d like people to remember in our assessment period:  

 

  • We always prefer to communicate with you directly, rather than a ward/CMHT/family member. We find messages get lost really quickly and we want you to have all the information, rather than someone else.  

  • Don’t tell us things you don’t feel safe/able to share. We want you to be okay and whilst information is really useful and helpful, it’s not more important than you being alright.  

  • Sometimes it might be hard for us to keep talking about something - it’s okay to stop.  

  • It’s okay to have a break if you need to! Please do come back though, even if it's just to say that’s it for today. We’ll worry otherwise.  

  • Sometimes people have found it easier to write stuff down than say it aloud. We will always welcome reading anything you choose to share with us.  

  • Fidget toys are often really useful for people! As is having a drink on hand.  

  • We’ll take notes throughout the assessment, which might feel weird while we’re scribbling away. We take lots of notes to make sure we’re getting it right. We are very happy for you to look at what we’ve written in session before we leave. We’ll never write anything we aren’t happy to share with you.  

  • We don’t live locally so there’s often a lot of travelling. We understand that there might be a time where you can’t make a session, that's okay but please tell us the day before if possible. Driving for 100 miles to find out we can’t see someone and then have to drive 100 miles home again is a miserable experience!  

 

After our 5th session we go away and write up what we’ve talked about together (this usually means we have a break for a couple of weeks between the 5th and 6th session). On the 6th session we come back and read through what we’ve written together. No one gets to see this before you do. For us it’s important that we’ve got it right, that what we’ve written is accurate and that we’re all in agreement. You can ask us to change things, delete bits you don’t agree with or tell us we’ve got things wrong. We’ll do our best to amend it to meet your needs. We know people have lots of experiences of professionals going off and writing things about people that then becomes gospel even when it might not be that accurate… sometimes the person it’s written about has never even seen it.  

You're assessing us too 

Once we’ve gone through the formulation with you, there will be a section at the end suggesting what we might do to be able to help and we’ll work out together if that fits with what you think you need.  

 

The basics will be:  

  • 2 sessions a week (or 1 if it’s a joint visit) to do what we decide will be helpful 

  • Phone contact 9am-9pm for extra support  

  • Helping everyone around you understand you in the same way as the formulation 

  • Advocating for the things that you identify as being important 

  

We don’t believe anyone should be ‘forced’ to have a relationship with anyone or to have therapy they don’t want. You make the choice to work with us or not.   

You can decide while we’re with you in our 6th session or have a think about it and get back to us, but we won’t be around any longer unless you decide you want us to be.  

 

😊