You will initially meet with two members of the team, who will complete an assessment and formulation with you. Once you have completed this, we will discuss your options and next steps with you. This is most likely to include a period of preparation for therapy and what we call ‘stabilisation’. This stabilisation might be the main task of your therapy with the team or we might decide together that you would benefit from Structured Clinical Management (SCM). Each of these is outlined below:
Assessment and formulation
Firstly, we need to find out about the things that are difficult for you and how these difficulties have developed. We will spend time thinking about your strengths and the things that have helped you manage these difficulties.
We do this by meeting with you regularly (usually weekly); this process can take a number of sessions but helps us get a good understanding of the best ways to meet your needs. Your assessors will discuss information sharing and confidentiality with you prior to the assessment. If you would like further information on this please ask staff for a copy of the Trusts leaflet ‘Information that the Trust keeps about you’.
At the end of the assessment, we will develop a shared formulation’ with you. A formulation is like a jigsaw that pulls everything together and helps us to make sense of your experiences. The assessment and formulation will help us decide together the best treatment approach for you. If ongoing treatment is to be provided by our service, you will then be helped to prepare for this as follows.
Preparation for therapy
The preparation stage helps you get ready to engage in the therapies we offer. During this period, we will work with you to develop goals, make plans to help you manage your safety in times of crisis, and develop treatment agreements (so you know exactly what to expect and what is asked of you), alongside treatment targets (so that we can make sure we are on track with your needs)
This type of work focuses on the difficulties people described as the result of multiple traumatic experiences, usually starting in early life. This can include flashbacks, nightmares, negative thoughts about yourself and other people, and unusual experiences such as voice hearing or other perceptual disturbances.
This may be the main treatment you would benefit from, or engaging in trauma stabilisation work may help you develop greater skills and stability to access other helpful therapies, such as SCM.
Structured Clinical Management (SCM)
Structured Clinical Management is an evidence based approach for people with personality difficulties and can help people to:
- Problem solve
- Manage crises
- Develop skills to manage emotions
- Reduce impulsivity or behaviours that place you at risk
- Improve interpersonal relationships
- Reduce self-harm and suicidality
The earlier preparation stage uses SCM principles and we may decide together to continue with the therapy part of this approach. If you want to read more about SCM there is a leaflet available on the Trust website.