Personality Disorder Services - Medium Secure Low Secure Tier 4 PD (NHSE) PD Intensive Support Highly Specialised PD (CCG) PD / Disordered Eating ...
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Personality
Disorder Services
> Medium Secure
> Low Secure
> Tier 4 PD (NHSE)
> PD Intensive Support
> Highly Specialised PD (CCG)
> PD / Disordered Eating Dual Diagnosis
> Community Rehabilitation
Next
Welcome Click the buttons to find
out more about our
Personality Disorder Services
Cygnet Health Care was established in
1988. Since then we have developed a
Introduction
wide range of services for individuals with Our expert and highly dedicated care We maintain a good relationship with our
mental health needs, autism and learning team of 10,000 employees empower quality regulators and undergo regular Our Model of Care
disabilities within the UK. We have built 2,864 individuals across 150 services to inspections, with 82% of our services Our myPath Care Model
a reputation for delivering pioneering consistently make a positive difference rated ‘Good’ or ‘Outstanding’. We also Global Assessment of Progress
services and outstanding outcomes for to their lives, through service user operate an internal system of quality care, (GAP) Outcomes
the individuals in our care. focused care and rehabilitation. treatment and positive outcomes. Example DBT Pathway
Outcomes
Medium Secure
Low Secure
Tier 4 PD (NHSE)
PD Intensive Support
Highly Specialised PD (CCG)
Contents PD / Disordered Eating Dual Diagnosis
Community Rehabilitation
Introduction 02 Highly Specialised PD (CCG) Case Study
Our Model of Care 06 Cygnet Acer Clinic, Derbyshire 18 Map
Our myPath Care Model 07 Cygnet Alders Clinic, Gloucestershire 19 Service User Reviews
Global Assessment of Progress (GAP) Outcomes 08 Cygnet Aspen Clinic, South Yorkshire 20 How to Make a Referral
Example DBT Pathway 09 Cygnet Hospital Bierley, West Yorkshire 21
Outcomes 10-11 Cygnet Hospital Maidstone, Kent 22
Medium Secure PD / Disordered Eating Dual Diagnosis
Cygnet Hospital Bury, North West 12 Cygnet Nield House, Cheshire 23
Low Secure Community Rehabilitation
Cygnet Hospital Clifton, East Midlands 13 Gledholt Mews and Coach House, West Yorkshire 24
Cygnet Hospital Derby, East Midlands 14 Case Study 25-26
Tier 4 PD (NHSE) Map 27
Cygnet Hospital Beckton, London 15 Service User Reviews 28
Cygnet Hospital Ealing, London 16 How to Make a Referral 29
PD Intensive Support
Cygnet Hospital Beckton, London 15
Cygnet Hospital Kewstoke, South West 17
2 | www.cygnethealth.co.uk Back Next
Click the buttons to find
out more about our
Personality Disorder Services
Introduction
Our Model of Care
Our myPath Care Model
Global Assessment of Progress
(GAP) Outcomes
Example DBT Pathway
Outcomes
Medium Secure
Low Secure
Tier 4 PD (NHSE)
PD Intensive Support
Highly Specialised PD (CCG)
PD / Disordered Eating Dual Diagnosis
Community Rehabilitation
Case Study
Map
Service User Reviews
How to Make a Referral
Introduction
O ur national network of specialist personality disorder services
offers over 250 beds across 13 services which provide
medium secure and low secure, emergency, tier 4 inpatient,
Our services offer a range of interventions including Dialectical
Behaviour Therapy (DBT) and Schema Focused Therapy, along
with a number of additional interventions to enhance service
highly specialised CCG funded personality disorder, dual users’ recovery journey. Managed Care Pathways are used to
diagnosis PD and disordered eating and community improve clinical effectiveness with a view to move service users
rehabilitation services. through the integrated personality disorder pathway and back
to independent community living.
Each of our personality disorder services offer a highly structured
environment designed to promote recovery. Care and support is
provided in therapeutic environments by comprehensive multi-
disciplinary teams.
3 | Personality Disorder Service Back Next
Our service user profile: Click the buttons to find
out more about our
> Diagnosis of personality disorder and associated mental health needs Personality Disorder Services
> May have forensic history
> May present with co-morbid presentations: Introduction
• Self-harm
18+ years Our Model of Care
Our myPath Care Model
• Self-neglect Global Assessment of Progress
(GAP) Outcomes
• History of substance misuse
Example DBT Pathway
• Complex needs
Outcomes
• Disordered eating Medium Secure
> May have a history of trauma and/or abuse Low Secure
Tier 4 PD (NHSE)
> May have experienced previous placement breakdowns
Male/Female PD Intensive Support
Highly Specialised PD (CCG)
PD / Disordered Eating Dual Diagnosis
Community Rehabilitation
Case Study
Map
Service User Reviews
How to Make a Referral
Mental Health Act Status:
Detained or Informal
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Personality Disorder Services
Introduction
Our services at a glance: Our Model of Care
Our myPath Care Model
> High staffing ratios
Global Assessment of Progress
> Dialectical Behaviour Therapy (DBT) (GAP) Outcomes
Example DBT Pathway
> Schema Focused Therapy
Outcomes
> Substance misuse / addictions treatment Medium Secure
> Self-harm treatment Low Secure
> Daily living skills Tier 4 PD (NHSE)
PD Intensive Support
> Cognitive Behavioural Therapy Highly Specialised PD (CCG)
> Anxiety management PD / Disordered Eating Dual Diagnosis
> Community and social involvement Community Rehabilitation
Case Study
> Vocational initiatives
Map
> Specialist PD pathway Service User Reviews
How to Make a Referral
Our multi-disciplinary teams:
> Consultant Psychiatrists and Specialty Doctors
> Psychology
> Occupational Therapy
> DBT practitioners
> Nurses
> Health care support workers
> Social workers
> Substance misuse practitioners
5 | Personality Disorder Service Back Next
Our Model of Care Click the buttons to find
out more about our
Personality Disorder Services
N Introduction
e I will live in an environment that enables me
w Our Model of Care
My Past
B Our myPath Care Model
I will be supported by specially trained staff
e Global Assessment of Progress
My Future
g
i
(GAP) Outcomes
The team supporting me will be resilient and striving
n Example DBT Pathway
n
i Outcomes
A specific model of care will be provided which offers a flexible
n Medium Secure
g Stage Five
s Low Secure
Transition & Discharge
Preparing to move on Tier 4 PD (NHSE)
>Relapse prevention PD Intensive Support
>Collaborative Highly Specialised PD (CCG)
Stage Three Stage Four update on risk
assessments and PD / Disordered Eating Dual Diagnosis
Stabilisation Active Treatment and Rehabilitation
Feeling safe Individualised therapy and improving quality of life
behavioural support
Community Rehabilitation
plans to share
>Psycho-education >Choice of individualised therapy >Sharing of skills learned in therapies with with future Case Study
support providers
groups (DBT Skills, such as: staff in reflective practice and CPA Map
Stage One Stage Two problem solving, • Modular Dialectical Behaviour >If required, specialist multi-model >Engaging family/
managing emotions, Therapy (DBT) interventions to minimise future risks
carers to Service User Reviews
Preadmission Assessment hearing voices etc.) support with
Preparation and Admission • Mentalisation Based Therapy (MBT) of harm to self and/or others e.g.:
discharge planning How to Make a Referral
Getting to know you
>Mindfulness • Cognitive Analytical Therapy (CAT) • Substance Misuse relapse prevention
>Skills generalisation
>Pre-admission >Relaxation • Interpersonal Therapy (IPT) • Life Minus Violence - Enhanced
>Establish to the community
assessment >Implementation • Schema Focussed Therapy (SFT) (LMV-E)
completed
therapeutic >‘ Moving On’ group
relationship
of sensory strategies
• Compassion Focussed Therapy (CFT) • Life Minus Violence for Harmful Sexual
(including review >Discharge planning
>Vocational and Behaviour (LMV-HSB)
of clinical records, >Undertake baseline • Cognitive Behavioural Therapy (CBT)
skills training • Fire-Setting Intervention
receipt of essential psychometric • EMDR
assessments >Occupational Programme (FIP-MO)
documentation • Combined Individual and group
such as HCR-20, >Medical
goal setting • Seeking Safety (Managing Substance
psychoanalytic approaches
START, PBS plan, assessment and >Ongoing Reflective Misuse for clients with a history
Practice, Training and
• Psychosocial nursing of trauma)
etc.) MDT discharge
advice on systemic • NICE guideline recommended >Thinking Minds (Cognitive Skills Training)
>Pre-admission care planning
support through medication regime
plan created >Occupational >Skills generalisation with OT
updating PBS plan >Occupational skills building
>Face to assessment of daily >Community reintegration, on-going
living skills and
for staff >Explore educational identity work
face assessment
/vocational pathway
> Advance sensory needs >Educational/ vocational pathways
provision of ward >Engaging family
and hospital and carers
information to >Collaborative
person in care and formulation
their family. Discuss development to
consent of family/ share with team via
carer involvement. reflective practice
>Completion of sessions and used
PCP tools and to inform PBS plan
advanced >Assessment of
preferences physical health
>Care planning
Enabling and Nurturing Environment
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Personality Disorder Services
Our myPath
Introduction
Our Model of Care
Our myPath Care Model
Care Model Global Assessment of Progress
(GAP) Outcomes
Example DBT Pathway
To ensure we cater for each person’s journey and achieve long-term Outcomes
results, we have created a unique approach to care for people with Medium Secure
personality disorder. Our aim is to support clients to work towards a goal of Low Secure
discharge in to community or step down settings following completion
Tier 4 PD (NHSE)
of treatment.
PD Intensive Support
myPath is our unique overarching care model which serves to monitor Highly Specialised PD (CCG)
service user engagement levels, manage their records, assess individual PD / Disordered Eating Dual Diagnosis
progress and formulate a personalised and dynamic care plan with
Community Rehabilitation
measurable targets.
Case Study
Within our personality disorder services, myPath is structured to support Map
individuals who require specialist therapeutic interventions including
Dialectical Behaviour Therapy (DBT) and Schema Focused Therapy. It is Service User Reviews
designed to help service users tackle their symptoms and progress with How to Make a Referral
their lives. In addition, these services support with preparation for an
independent life within the community, or for moving on to
mainstream rehabilitation.
For each individual, a daily risk assessment is completed, which enables
dynamic responses to individual presentation within any 24 hour period
enabling immediate support to be provided. Each individual is offered
a minimum of 25 hours meaningful activity, which is evidenced and
documented within an individualised activity timetable based around
understanding mental health needs, effective coping strategies and
reinforcing daily living skills. Each individual’s care pathway is reviewed
in full by the multi-disciplinary team on a weekly basis and guided by
a dynamic care plan which is closely linked to our specialist outcome
tool, the Global Assessment of Progress (GAP). In our personality disorder
services, the GAP allows us to measure an individual’s progress during their
admission, plot the positive developments and changes in well-being whilst
formulating plans over potential future risks for longer term management. In
applying myPath, the team around the individual is able to be responsive
in their approach and use myPath to determine length of stay, ensuring
that people move as quickly as possible to the most appropriate and least
restrictive environment.
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Click the buttons to find
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Personality Disorder Services
Introduction
Our Model of Care
Our myPath Care Model
Global Assessment of Progress
(GAP) Outcomes
Global Assessment of
Example DBT Pathway
Outcomes
Medium Secure
Progress (GAP) Outcomes Low Secure
Tier 4 PD (NHSE)
PD Intensive Support
The Global Assessment of Progress (GAP) is our specialist outcome tool used within our Highly Specialised PD (CCG)
Personality Disorder services. The tool allows us to measure an individual’s progress throughout PD / Disordered Eating Dual Diagnosis
their placement, plot the positive developments, setbacks and changes in wellbeing but also
Community Rehabilitation
identify the warning signs of any possible deterioration, whilst informing care planning and
being transparent about future risks. Case Study
Map
60 Service User Reviews
n=94
How to Make a Referral
40 9.0
or 22%
52
43 average increase
in score
p
Example Dialectical Click the buttons to find
out more about our
Behaviour Therapy Pathway
Personality Disorder Services
Introduction
Our Model of Care
Pre-admission assessment Our myPath Care Model
> Including assessment of willingness and capacity to engage in DBT and Global Assessment of Progress
the suitability of the programme in meeting the service user's needs (GAP) Outcomes
Example DBT Pathway
Outcomes
Admission
Medium Secure
> Psychological / DBT assessment and formulation Low Secure
> Assess motivation to engage in DBT Tier 4 PD (NHSE)
> Explain 4-miss rule (if a service user misses 4 consecutive sessions they PD Intensive Support
have ‘opted out’ of DBT) Refer back to Highly Specialised PD (CCG)
> Baseline outcome measures administered
psychology PD / Disordered Eating Dual Diagnosis
for other Community Rehabilitation
intervention Case Study
If motivated If not motivated Map
Presentation and Service User Reviews
Motivation work
allocation at DBT consult How to Make a Referral
DBT programme pre-commitment work
> Service user and therapist sign DBT contract
> Agree DBT enrolment date in line with next module start
Begin comprehensive DBT
> One standard treatment cycle = 2 x 6 month rounds
> Psychometric measures to be readministered every 6 months
Individual Skills Training Skills
Therapy Group Coaching
Completion of DBT
> Psychometric measures to be readministered at end of programme
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Personality Disorder Services
Introduction
Our Model of Care
Our myPath Care Model
Global Assessment of Progress
Outcomes
(GAP) Outcomes
Example DBT Pathway
Outcomes
Sample DBT outcomes from New Dawn Ward, Medium Secure
Cygnet Hospital Beckton Low Secure
Tier 4 PD (NHSE)
The outcome measures collected map to the difficulties associated
PD Intensive Support
with Emotionally Unstable Personality Disorder and the areas that the
DBT programme aims to address. Highly Specialised PD (CCG)
PD / Disordered Eating Dual Diagnosis
Data is collected before enrolment in the DBT programme, at 6 months
Community Rehabilitation
(following the first cycle of DBT skills modules) and again at 12 months
(following completion of the second cycle of skills modules.) Case Study
Map
Service User Reviews
40 How to Make a Referral
20
0
Pre Program 6 Months 12 Months
The Rosenberg Self-Esteem Scale measures a person’s level of self-esteem based on their
perceptions of themselves, both individually and comparison with others. Scores range
from 0-30, with higher scores indicating a higher level of self-esteem.
An increase in scores may suggest that individuals have developed a more positive
orientation towards their self-worth over the course of the DBT programme.
Data presented from 20 service users who completed 12 months of DBT.
10 | www.cygnethealth.co.uk Back NextClick the buttons to find
120 out more about our
Personality Disorder Services
100
Introduction
80 Our Model of Care
Our myPath Care Model
60 Global Assessment of Progress
(GAP) Outcomes
40 Example DBT Pathway
Outcomes
20 Medium Secure
Low Secure
0 Tier 4 PD (NHSE)
Pre Program 6 Months 12 Months
PD Intensive Support
The Difficulties in Emotion Regulation Scale (DERS) assesses typical levels of emotion Highly Specialised PD (CCG)
dysregulation across 6 domains. Higher scores indicate higher levels of
PD / Disordered Eating Dual Diagnosis
emotion dysregulation.
Community Rehabilitation
Overall scores indicate a reduction in overarching emotion dysregulation difficulties, also Case Study
noted on each of the measured domains. This suggests that individuals have a greater
Map
awareness, clarity and acceptance of their emotions.
Service User Reviews
How to Make a Referral
120
100
80
60
Average length
40 of stay is
20
13
0
Pre Program 6 Months 12 Months
months
Across Tier 4 and CCG
The Five Factor Mindfulness Scale measures five facets of mindfulness: observing, PD services (2019/20)
describing, acting with awareness, non-judging of inner experience and non-reactivity
to inner experience.
Overall increases are noted in relation to mindfulness and this is found across all five
measured facets.
Data presented from 20 service users who completed 12 months of DBT.
11 | Personality Disorder Service Back NextCygnet Hospital Bury, North West Click the buttons to find
Buller Street, off Bolton Road, Bury, North West BL8 2BS out more about our
Personality Disorder Services
Medium Secure
Introduction
18+ years Male 26 beds in 2 wards Our Model of Care
Our myPath Care Model
Global Assessment of Progress
C ygnet Hospital Bury offers a dedicated personality disorder The model of treatment is based on the principles of the recovery (GAP) Outcomes
service on two wards, Columbus and Madison, in a medium model including psychological therapies, occupational therapy, Example DBT Pathway
secure setting. Both wards deliver care for men with enduring social therapy, physical healthcare and medication. Outcomes
mental health needs, co-morbidity and behaviours which Medium Secure
Staff are trained to provide a pattern of care that continuously
challenge in a calm, therapeutic environment with a focus on
challenges maladaptive patterns of behaviour and provides Cygnet Hospital Bury, North-West
service user experience, shared care and safety.
ongoing opportunities to learn and try out more adaptive Low Secure
There are five core treatment phases used courses of action and we use the myPath framework to focus Tier 4 PD (NHSE)
across both wards: interventions towards a service user’s future life outside hospital. PD Intensive Support
1 Preadmission/Preparation Highly Specialised PD (CCG)
Service user survey results PD / Disordered Eating Dual Diagnosis
2 Assessment and admission/Getting to know you
Each service user at Cygnet Hospital Bury is given the opportunity Community Rehabilitation
3 Stabilisation/Feeling safe to complete an individual satisfaction survey. Case Study
4 ctive treatment and rehabilitation/individualised therapy
A Map
93%
and improving quality of life
Service User Reviews
5 Transition and discharge/Preparing to move on How to Make a Referral
of individuals
Therapies and activities have confidence and
trust in the nursing staff
Each service user has a treatment plan and a weekly therapeutic
Our facilities:
100%
timetable which can include:
> Individual and group psychology
> En-suite bedrooms
> Counselling for drug and alcohol misuse of individuals feel they are given choices, and are > Gym
involved with choosing the types of therapies
> Anger management /groups that are provided to them
> Laundry
> > Occupational therapy kitchen
86%
Social skills development
> Daily living skills development
of individuals have always > Therapy garden
felt safe during their time
> Healthy living at Columbus Ward
> IT skills training
>
>
Education and vocational development
Group games and activities
100%
of individuals feel
ward staff are caring
and supportive
*Results taken from Columbus Ward 2020 service user surveys
12 | www.cygnethealth.co.uk Back NextCygnet Hospital Clifton, East Midlands Click the buttons to find
Clifton Lane, Clifton, Nottinghamshire, East Midlands NG11 8NB out more about our
Personality Disorder Services
Low Secure
Introduction
18+ years Male 24 beds across 2 wards Our Model of Care
Our myPath Care Model
Global Assessment of Progress
C ygnet Hospital Clifton is a 24 bed specialist low secure The hospital is set out across two wards: (GAP) Outcomes
service for men with a personality disorder, who also present Example DBT Pathway
Ancaria Ward is the admissions/initial treatment ward, which
with complex mental health needs and behaviours Outcomes
focuses on rehabilitation, in preparation for moving on into the
that challenge. community or supported living. Medium Secure
At Cygnet Hospital Clifton we create opportunities for sustained Low Secure
Acorn Ward focusses on rehabilitation, to prepare for amove into
positive behavioural change. We achieve this by applying a the community or supported accomodation. Cygnet Hospital Clifton, East Midlands
consistent approach where the men in our care feel Cygnet Hospital Derby, East Midlands
encouraged to develop positive interpersonal skills to At Cygnet Hospital Clifton we aim to sequence Tier 4 PD (NHSE)
reduce challenging behaviours. interventions according to Professor Livesley’s integrated
PD Intensive Support
treatment model. The therapeutic milieu aims to ensure
Our interventions and approaches are matched according consistency and optimal conditions for growth and change in a Highly Specialised PD (CCG)
to individual needs informed by dynamic case formulation. positive and effective environment. PD / Disordered Eating Dual Diagnosis
Our team constantly adapt their engagement techniques Community Rehabilitation
and the personnel delivering specific interventions to maximise Prison Transfers Case Study
engagement and create optimum opportunity for progress to be
made with the men in our care. We also offer a specialised three month prison transfer Map
programme, for stabilisation and assessment of prisoners whose Service User Reviews
Alongside appropriate pharmacological treatments to stabilise mental health needs cannot be met in the prison environment.
diagnosed mental illness, we support the men in our care with How to Make a Referral
a range of psychology-led interventions. These aim to develop We provide a rapid response to referrals, and a speedy
self-regulation skills facilitating the improved control of assessment within the prison environment. Following admission,
impulsive behaviours. we offer a comprehensive inpatient assessment process including
robust risk assessment, detailed treatment planning, and Our multi-disciplinary team:
recommendations for onward moves.
> Consultant Forensic Psychiatrist
Cygnet Hospital Clifton has
helped me with my recovery > Forensic Psychologist
by challenging my behavioural > Occupational Therapist
problems and changing my
thoughts to move to a more > Social Worker
positive way, giving me more > Nurse leads
confidence to deal with different > Social Therapy leads
disappointments, changing my
ways of thinking and giving me
responsibility with (a course on)
the Recovery College.
- Service user
13 | Personality Disorder Service Back NextCygnet Hospital Derby, East Midlands Click the buttons to find
100 City Gate, London Road, Derby, East Midlands DE24 8WZ out more about our
Personality Disorder Services
Low Secure
Introduction
18+ years Female 16 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
A lvaston Ward at Cygnet Hospital Derby is a 16 bed specialist Enabling Environments Award (GAP) Outcomes
low secure service for women with a primary diagnosis Example DBT Pathway
of emotionally unstable personality disorder. The ward can Alvaston Ward has achieved the Enabling Environments
Outcomes
support women with highly complex needs and those who have Award from the Royal College of Psychiatrists’ Centre for
Quality Improvement. Medium Secure
experienced previously unsuccessful placements. Low Secure
Enabling Environments is awarded to services who have
The primary pre-cursor to an admission to Alvaston Ward is that Cygnet Hospital Clifton, East Midlands
demonstrated an outstanding level of best practice in creating
the person is ready to engage in a therapeutic programme. Cygnet Hospital Derby, East Midlands
and sustaining a positive and effective social environment. To
Service users may have a history of involvement in the criminal Tier 4 PD (NHSE)
achieve the award Alvaston Ward had to meet and exceed ten
justice system or may present with significantly challenging PD Intensive Support
core standards based on:
behaviour, severe self-neglect and vulnerability.
Highly Specialised PD (CCG)
The ethos on Alvaston Ward is to provide assertive treatment of
> Belonging
PD / Disordered Eating Dual Diagnosis
a person’s condition. The multi-disciplinary team helps individuals > Boundaries Community Rehabilitation
address their issues and proactively use Dialectical Behaviour
Therapy (DBT) and Schema Therapy. The DBT programme is
> Communication Case Study
adapted to the needs of the service users and is tailored for > Development Map
individuals who may have educational or learning difficulty issues, Service User Reviews
such as dyslexia, which may act as barriers to the standard
> Involvement
How to Make a Referral
DBT programme. > Safety
> Structure
> Empowerment Our facilities:
> Leadership > En-suite bedrooms
> Openness > External secure courtyard
> Fully equipped gym
> Art room
> IT classroom
> Therapy kitchen
14 | www.cygnethealth.co.uk Back NextCygnet Hospital Beckton, London Click the buttons to find
23 Tunnan Leys, Beckton, London E6 6ZB out more about our
Personality Disorder Services
Tier 4 PD (NHSE) PD Intensive Support
Introduction
18+ years Female 33 Beds in 2 Wards Our Model of Care
Our myPath Care Model
Global Assessment of Progress
C ygnet Hospital Beckton has two specialist personality New Dawn Ward is our 18 bed specialist Tier 4 Personality Disorder (GAP) Outcomes
disorder wards, New Dawn Ward and Upping Ward. Our aim service. Women can be admitted to New Dawn Ward if they Example DBT Pathway
is to support individuals’ recovery and integration back into the have a diagnosis of personality disorder, exhibit self-harming Outcomes
community, as quickly as possible. We have a multi-disciplinary behaviour and are able to accept the need for help. Service
Medium Secure
team of specialists and offer a very broad range of therapies. users can be informal or detained under the Mental Health Act.
Low Secure
Upping Ward is our 15 bed Intensive Support Service for women The service is structured so that there are two distinct areas in Tier 4 PD (NHSE)
with a diagnosis of personality disorder and complex mental the ward aligned with the care pathway; pre-engagement and
Cygnet Hospital Beckton, London
health needs. The service pathway provides a robust programme engagement. Following admission, a 12 week assessment period
is undertaken to establish needs and determine the appropriate Cygnet Hospital Ealing, London
of care for women with challenging high risk behaviour who
experience difficulties with engagement or motivation with treatment pathway. Upon completion of the 12 weeks’ PD Intensive Support
therapeutic programmes. We aim to meet the needs of these assessment, a clear pathway will be formulated with the service Cygnet Hospital Beckton, London
women, who may have had previous inappropriate placements, user and discussed in their first CPA (Care Programme Cygnet Hospital Kewstoke, South West
in a less restrictive setting. Approach) meeting.
Highly Specialised PD (CCG)
PD / Disordered Eating Dual Diagnosis
Community Rehabilitation
Therapy Programme/Approach Case Study
Across both Upping Ward and New Dawn Ward, we use a variety of different therapeutic models which are delivered in a Map
systemic and integrated way. The model used at Upping Ward embraces a wide range of evidence-based interventions such
Service User Reviews
as DBT, CBT, Schema, mindfulness along with alternative therapies such as art therapy and music therapy in order to respond
to service user underlying needs (affective, behavioural, cognitive, physiological and spiritual) through flexibility and effective How to Make a Referral
therapeutic programs that will facilitate the process from engagement and assessment to rehabilitation, discharge and recovery.
Dialectical Behaviour Therapy (DBT) is the main programme the needs of individuals particularly where the service user
of therapy used on New Dawn Ward. The care pathway is may have an area of cognitive difficulty that impacts their
structured in phases which includes a comprehensive clinical, ability to engage and process. There are various options
psychometric assessment and formulation within 4-6 weeks available on how this is delivered for people experiencing
of admission. attention, concentration or motivational difficulties including
conversational, experiential learning and visual aid approaches.
Adherent DBT pathway Features two cycles of skills training,
This is then supported with further individualised practice on
weekly 1:1 therapy, ad hoc skills coaching and 1:1 crisis
a 1:1 basis.
management therapy. Service users who are motivated and
show commitment to DBT will undertake the full programme. Alternative therapeutic interventions We also provide
alternative NICE Guideline recommended therapies including
Adapted DBT pathway We recognise that standard DBT is
Cognitive Analytic Therapy (CAT), psychodynamic techniques
not suitable for everyone, so we also provide an adapted
and Schema Therapy.
programme, based within the DBT framework but tailored to
15 | Personality Disorder Service Back NextCygnet Hospital Ealing, London Click the buttons to find
22 Corfton Road, Ealing, London W5 2HT out more about our
Personality Disorder Services
Tier 4 PD (NHSE)
Introduction
18+ years Female 9 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
N ew Dawn Ward at Cygnet Hospital Ealing is a 9 bed (GAP) Outcomes
specialist Tier 4 service, providing treatment, care and Example DBT Pathway
support for women with a personality disorder who are ready to Outcomes
engage in therapy. Medium Secure
Our service can support women who have a diagnosis of Low Secure
personality disorder and who need either: Tier 4 PD (NHSE)
> A short-term crisis intervention utilising a DBT model Cygnet Hospital Beckton, London
(i.e. emergency referrals) Cygnet Hospital Ealing, London
> A longer term therapeutic treatment programme utilising PD Intensive Support
the principles of DBT with skills coaching and Highly Specialised PD (CCG)
individual therapy. PD / Disordered Eating Dual Diagnosis
New Dawn Ward offers a programme that is well-structured to Community Rehabilitation
give service users the opportunity to address and deal with their Case Study
problems in a safe environment. Cygnet Hospital Ealing also Therapies and activities Map
provides a specialist Eating Disorder service on Sunrise Ward, so
service users have access to a dietician if required. We have
> Dialectical Behaviour Therapy (DBT), including daily Service User Reviews
Skills Training and Skills Homework Group
close links with Cygnet Lodge Kenton which can be used as a How to Make a Referral
‘step-down’ unit from the New Dawn service. > Daily activities offered by the occupational therapy
team, including self-nurturing, cooking, creative
Planning for discharge starts at admission and all treatment
and walking groups
and interventions are geared towards preparing a person for
successfully and positively leaving the service. After discharge, > Specialist groups including body image and
When I had extremely difficult times,
contact will be maintained with the service user’s own healthy relationships (run for a set number of weeks) the team didn’t give up on me and
Community Mental Health Team to offer ongoing support move me on. The DBT the ward taught
and advice.
> Drama therapy with music and really helped me. - Service user
creative therapies
> Service users suggest ward activities through a
fortnightly community meeting
> Carers group once a month
> Monthly leavers group for individuals who have
been discharged from the ward to come and
speak about their experiences post-discharge
> Family Therapy
> Yoga and massage
16 | www.cygnethealth.co.uk Back NextCygnet Hospital Kewstoke, Weston-super-Mare Click the buttons to find
Beach Road, Kewstoke, Weston-super-Mare, South West BS22 9UZ out more about our
Personality Disorder Services
PD Intensive Support
Introduction
18+ years Female 15 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
K nightstone Ward at Cygnet Hospital Kewstoke is our new 15 Through our Care Pathway at Knightstone Ward, we are able to (GAP) Outcomes
bed Intensive Support Service for women with a diagnosis help support and treat women who present with complex needs, Example DBT Pathway
of personality disorder and complex mental health needs. The including emotionally unstable personality disorder (EUPD) Outcomes
service helps women with challenging high risk behaviours, and significant self-harm. Medium Secure
who experience difficulties with engagement or motivation
By offering a robust, safe environment and skilled staffing team we Low Secure
with therapeutic programmes. We aim to help meet the needs
are able to help women who previously may have had difficulties Tier 4 PD (NHSE)
of these women, who may have previously had inappropriate
engaging in therapeutic programmes. Our care pathway will Cygnet Hospital Beckton, London
placements, by offering a less restrictive setting underpinned by
focus on an integrated programme structure, which will enable
our robust service pathway and programme of care. Cygnet Hospital Ealing, London
a focus on positive pre-engagement, offering a variety of
approaches. The main aim of Knightstone Ward is to help prepare PD Intensive Support
the individuals in our care with the required appropriate skills to Highly Specialised PD (CCG)
Service user profile: move to a Tier 4 pathway or step-down services, discharges to PD / Disordered Eating Dual Diagnosis
community services or independent living where appropriate. Community Rehabilitation
> Women, aged 18+ years
Case Study
> Detained under the Mental Health Act Map
> Primary diagnosis of personality disorder Service User Reviews
Therapeutic approaches
> Presenting with complex high risk and assessments: How to Make a Referral
needs including:
• Significant self-harm
> Dialectical Behaviour Therapy (DBT)
• Emotionally unstable > Cognitive Behavioural Therapy (CBT)
personality disorder (EUPD) > Schema Focused Therapy
> Demonstrating difficulties with engagement or
> Occupational therapy assessment
motivation with therapeutic programmes
and interventions
> May have a history of repeated
> Psychological formulations
hospital admissions or previous
placement breakdown > Music therapy
> Art therapy
> Mindfulness
> Sensory assessments
> Complementary therapies including reiki
and aromatherapy
> Wellness Recovery Action Plan (WRAP)
17 | Personality Disorder Service Back NextCygnet Acer Clinic, Derbyshire Click the buttons to find
Worksop Road, Chesterfield, Derbyshire, East Midlands S43 3DN out more about our
Personality Disorder Services
Highly Specialised PD (CCG)
Introduction
18+ years Female 14 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
A cer Lower at Cygnet Acer Clinic is a 14 bed rehabilitation (GAP) Outcomes
service providing assessment, treatment and rehabilitation Example DBT Pathway
Service user profile:
for women with personality disorder and complex needs. Outcomes
> START assessments Medium Secure
Rehabilitation is provided in a therapeutic environment, with
a level of security matched to individual needs. The aim of the > Integrated approach combining different Low Secure
treatment, rehabilitation and re-socialisation programme is to models of therapy (CBT, DBT and Tier 4 PD (NHSE)
prepare the people in our care either for transfer to conditions of Schema informed) PD Intensive Support
lesser security, or for a life in the community.
> Pre-engagement group Highly Specialised PD (CCG)
Our dedicated clinical teams provide a multi-disciplinary Cygnet Acer Clinic, Derbyshire
> Personality Disorder psychoeducation
approach to rehabilitation. This includes psychology (including Cygnet Alders Clinic, Gloucestershire
forensic psychology input) occupational therapy, social work and > Mindfulness
Cygnet Aspen Clinic, South Yorkshire
vocational training.
> Systems Training for Emotional Predictability Cygnet Hospital Bierley, West Yorkshire
and Problem Solving (STEPPS)
Cygnet Hospital Maidstone, Kent
Therapeutic approaches > Wellness Recovery Action Plan (WRAP) and PD / Disordered Eating Dual Diagnosis
‘My Safety Plan’ Community Rehabilitation
and assessments:
> Comprehensive community links to support Case Study
> Dialectical Behaviour Therapy (DBT) vocational/educational, self-care and Map
> Cognitive Behavioural Therapy (CBT) leisure opportunities
Service User Reviews
> Schema Focused Therapy How to Make a Referral
> Occupational therapy assessment
and interventions
> Psychological formulations
> Music therapy I have been discharged for nearly
> Art therapy
four months now and I am doing
so much better than I ever thought
> Mindfulness I would. And this is because of the
> Sensory assessments staff at Acer believing in me when I
didn’t. The skills I have learnt help me
> Complementary therapies including reiki
everyday. Acer has given me my
and aromatherapy
life back and for that I will be forever
> Wellness Recovery Action Plan (WRAP) grateful! - Former Service User
18 | www.cygnethealth.co.uk Back NextCygnet Alders Clinic, Gloucestershire Click the buttons to find
155 Podsmead Road, Gloucestershire, South-West GL1 5UA out more about our
Personality Disorder Services
Highly Specialised PD (CCG)
Introduction
18+ years Female 20 beds in 3 wards Part of the Welsh Hospital Framework Our Model of Care
Our myPath Care Model
Global Assessment of Progress
C ygnet Alders Clinic is a 20 bed rehabilitation service Through this eclectic approach, and with a focus on the (GAP) Outcomes
providing assessment, treatment and rehabilitation for importance of therapeutic relationships, we deliver an integrated Example DBT Pathway
women with personality disorder and complex needs. Cygnet combination of pharmacologic and psychotherapeutic Outcomes
Alders Clinic is on the Welsh Hospital Framework with specialist interventions. The aim is to address the core features of personality Medium Secure
service status. disorder: problems with emotional regulation, interpersonal
Low Secure
functioning, and self-identity and to prepare the women in our
We provide a specialist psychologically informed personality Tier 4 PD (NHSE)
care for a transition to life in the community.
disorder pathway across three living areas; from Severn, for PD Intensive Support
assessment and stabilisation, through to Avon, where service Therapeutic interventions and psychological formulations are Highly Specialised PD (CCG)
users move to as they engage and progress with their treatment tailored to individual need and utilise techniques drawn from
Cygnet Acer Clinic, Derbyshire
pathway; and finally Coln, for a focus on community transition. major therapeutic orientations such as:
Cygnet Alders Clinic, Gloucestershire
Our approach > Dialectical Behaviour > Compassion Focused
Cygnet Aspen Clinic, South Yorkshire
Therapy (DBT) Therapy (CFT)
At Cygnet Alders Clinic we adopt an integrated modular Cygnet Hospital Bierley, West Yorkshire
approach to treatment for women with a diagnosis of personality > Cognitive Behavioural > Mentalization Based
Therapy (CBT) Treatment (MBT) Cygnet Hospital Maidstone, Kent
disorder, accounting for diagnostic differences, NICE guidelines
> Schema Therapy PD / Disordered Eating Dual Diagnosis
and the work of Livesley (2004).
Community Rehabilitation
Case Study
Map
Our pathway
Service User Reviews
How to Make a Referral
Severn Avon Coln
Assessment and
Stabilisation Core Treatment Consolidation
Alders has changed my life…After
> Safety > Exploration > Integration
18 years of being in hospital I finally
> Containment > Change > Synthesis have a future! - Service User
> Emotional and behavioural > Cognitive, interpersonal, > Relapse prevention
control and regulation occupational and specific > Transition
> Crisis management psychosocial interventions
> Discharge planning
> Individualised psychological > Individualised psychological
> Multi-agency working
formulation formulation
> Increased independence
> Resilience
19 | Personality Disorder Service Back NextCygnet Aspen Clinic, South Yorkshire Click the buttons to find
Manvers Road, Mexborough, Doncaster, South Yorkshire, Yorkshire & Humber S64 9EX out more about our
Personality Disorder Services
Highly Specialised PD (CCG)
Introduction
18+ years Female 16 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
C
(GAP) Outcomes
ygnet Aspen Clinic is a specialist service for women with a Therapeutic approaches and assessments
diagnosis of personality disorder and associated complex Example DBT Pathway
Our therapeutic interventions are tailored to individual presenting
needs. We provide assessment, stabilisation, treatment and Outcomes
needs, based on comprehensive psychological formulations
rehabilitation for up to 16 women. Medium Secure
undertaken on admission. The assessment tools we use include:
Our service users may have complex trauma histories or have Low Secure
experienced regular placement breakdowns. At Cygnet Aspen > Structured Clinical > Chart of Interpersonal Tier 4 PD (NHSE)
Clinic we provide a collaborative, multi-disciplinary approach to Interview for PD Reactions in Closed Living
PD Intensive Support
care and treatment with a focus on recovery and co-production (SCID-5-PD) Environments (CIRCLE)
Highly Specialised PD (CCG)
with service users. > Millon Clinical Multiaxial > Aspects of Identity Cygnet Acer Clinic, Derbyshire
Inventory (MCMI) Questionnaire (AIQ)
Our approach – a modular treatment pathway Cygnet Alders Clinic, Gloucestershire
> Difficulties in Emotion > Warwick-Edinburgh Cygnet Aspen Clinic, South Yorkshire
> At Cygnet Aspen Clinic we operate an integrated modular Regulation Scale (DERS) Mental Well-being Scale
approach to treatment for women with a diagnosis of Cygnet Hospital Bierley, West Yorkshire
(WEMWBS)
personality disorder, accounting for diagnostic differences, > Beck Anxiety Inventory Cygnet Hospital Maidstone, Kent
NICE guidelines and the work of Livesley (2004). (BAI), Beck Depression > Model of Human PD / Disordered Eating Dual Diagnosis
Inventory (BDI), Beck Occupation Screening
> Our multi-modal treatment pathway consists of a range of Hopelessness Scale (BHS) Tool (MOHOST)
Community Rehabilitation
therapeutic models including Dialectical Behaviour Therapy Case Study
(DBT), Trauma-focused Cognitive Behavioural Therapy (TF- > The Awareness of Social > Assessment of Map
CBT), Trauma-focused Compassion Focused Therapy Inference Test (TASIT) Communication and
Interaction Skills (ACIS) Service User Reviews
(TF-CFT) and Schema Therapy techniques.
How to Make a Referral
Regulation and
modulation
I cannot express how amazing the
staff here are! They saved me from
Interpersonal Identity myself and took the responsibility to
keep me safe until I could do it for
myself. I will never be able to thank
them enough for the way they helped
me and the huge impact they have
had on my life. - Service User
20 | www.cygnethealth.co.uk Back NextCygnet Hospital Bierley, West Yorkshire Click the buttons to find
Bierley Lane, Bradford, West Yorkshire, Yorkshire & Humber BD4 6AD out more about our
Personality Disorder Services
Highly Specialised PD (CCG)
Introduction
18+ years Female 16 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
B owling Ward at Cygnet Hospital Bierley is a 16 bed specialist (GAP) Outcomes
service for women with highly complex needs associated Other therapies and activities: Example DBT Pathway
with a diagnosis of emotionally unstable personality disorder. Outcomes
The service aims to support service users to learn effective > Mindfulness Medium Secure
emotional management, to reduce emotional dysregulation > Wellness Recovery Action Plan (WRAP) Low Secure
and to manage their own mental health and recovery.
> Daily Living skills Tier 4 PD (NHSE)
Bowling Ward provides a highly structured environment. All PD Intensive Support
service users have individualised ward therapy programmes, > Recovery College Highly Specialised PD (CCG)
alongside a personal programme of activities and interests. The > Comprehensive community links to support Cygnet Acer Clinic, Derbyshire
Therapies Department use a whole-person approach to work with vocational/educational, self-care and
service users to identify which treatments are most helpful to their Cygnet Alders Clinic, Gloucestershire
leisure opportunities
recovery based on assessment of their needs. Cygnet Aspen Clinic, South Yorkshire
Bowling Ward works upon the principles of positive risk-taking and Cygnet Hospital Bierley, West Yorkshire
encouraging self-management. Service users are encouraged Cygnet Hospital Maidstone, Kent
to make steps towards independence whilst having access to the PD / Disordered Eating Dual Diagnosis
Dialectical Behaviour Therapy (DBT) programme and the support Community Rehabilitation
of the Bowling Ward team. The aim is to enable and empower Case Study
service users to move towards independence and recovery
Map
through practicing the skills they’ve achieved in a
safe environment. Service User Reviews
How to Make a Referral
Before I went onto Bowling Ward I was
Fully comprehensive DBT programme: 5 treatment modes intent on destroying myself, if it wasn’t
for DBT I wouldn’t be where I am
today. - Service User
Skills training Individual Skills coaching Structuring the Therapist
group therapy environment consultation
The DBT programme on Bowling Ward received an “Excellence in DBT Award” in 2017 from the Association of Psychological Therapies.
21 | Personality Disorder Service Back NextCygnet Hospital Maidstone, Kent Click the buttons to find
Gidds Pond Way, Weavering, Maidstone, Kent, South-East ME14 5FY out more about our
Personality Disorder Services
Highly Specialised PD (CCG)
Introduction
18+ years Female 16 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
R
(GAP) Outcomes
oseacre Ward is our service for women with a personality Our therapeutic approaches:
disorder at Cygnet Hospital Maidstone, a newly built state-of- Example DBT Pathway
Our therapeutic interventions are tailored to individual presenting
the-art facility situated in the Kent Medical Campus. Roseacre Outcomes
needs, based on comprehensive psychological formulations
Ward is designed to a Tier 4 specification but commissioned by Medium Secure
undertaken on admission. The assessment tools we use include:
CCGs. Building on the expertise of the other personality disorder
Low Secure
services within the Cygnet Health Care portfolio, Roseacre Ward > Dialectical Behaviour Therapy (DBT), including 1:1 sessions
further complements our comprehensive national network of and group skills training. DBT is a proactive behavioural Tier 4 PD (NHSE)
specialist services for women with this diagnosis. therapy, requiring active engagement, designed to support PD Intensive Support
individuals to manage distress, regulate emotion and Highly Specialised PD (CCG)
Roseacre Ward is highly specialised in terms of the programmes
develop adaptive coping. Cygnet Acer Clinic, Derbyshire
we operate, and the service is supported by Dialectical
Behaviour Therapy (DBT). Our comprehensive multi-disciplinary > Care planning is supported by a model of Positive Cygnet Alders Clinic, Gloucestershire
team includes a Consultant Psychiatrist, Clinical Psychologist, Behaviour Support (PBS) and each service user will have a Cygnet Aspen Clinic, South Yorkshire
Occupational Therapists, DBT Therapists and a nursing and personalised, co-produced Positive Behaviour Support plan Cygnet Hospital Bierley, West Yorkshire
support work team. The aim of the service is to support individuals in place to inform their care and treatment pathway.
Cygnet Hospital Maidstone, Kent
to manage their mental health, develop coping strategies,
reinforce daily living skills and prepare for a return to
> The service is also supported by our tried and tested PD / Disordered Eating Dual Diagnosis
myPath model. To ensure we cater for each individual’s Community Rehabilitation
independent life.
journey and achieve long-term results, we have created
Case Study
The service operates in partnership with Kent and Medway a unique approach to care for people with personality
NHS and Social Care Partnership Trust. This partnership helps disorder. myPath ensures the delivery of high quality and Map
integrate the Hospital into local and regional care pathways and inclusive care which is continually evaluated through robust Service User Reviews
community services, with the focus on care close to families and operational and clinical governance frameworks. How to Make a Referral
friends, shortest length of hospital stay, and reducing the
chances of re-admission.
Our facilities:
Just wanted to say thank you so much to all the staff > En-suite bedrooms
at Cygnet. I’m doing really well in the community. I’ve > Outside space including ward garden and
started volunteering and I’m over 270 days self harm communal roof terrace
free. The care I received was amazing and I can’t
thank the staff enough for helping me get to where I > Therapy kitchen
am now. - Former Service User > Quiet room
> Gym and external exercise area
> Extensive therapy space including Recovery College
classrooms
> Library and movies room
22 | www.cygnethealth.co.uk Back NextCygnet Nield House, Cheshire Click the buttons to find
Barrows Green, Bradfield Road, Crewe, Cheshire, North West CW1 4QW out more about our
Personality Disorder Services
PD / Disordered Eating Dual Diagnosis
Introduction
18+ years Female 15 beds Our Model of Care
Our myPath Care Model
Global Assessment of Progress
C larion Ward at Cygnet Nield House is a complex personality (GAP) Outcomes
disorder service for women with a dual diagnosis of Example DBT Pathway
personality disorder and co-morbid disordered eating. Both Our therapies and interventions: Outcomes
aspects can be treated simultaneously, with the appropriate > Compassion focused therapy (CFT) Medium Secure
specialist therapeutic input provided.
> Cognitive Behavioural Therapy (CBT) Low Secure
Clarion Ward adopts a phased treatment pathway which aims Tier 4 PD (NHSE)
to help the individual service user understand and plan their > Informed Dialectical Behaviour Therapy (DBT) PD Intensive Support
journey through treatment. The service focuses on the need for > Acceptance and Commitment Therapy (ACT) Highly Specialised PD (CCG)
treatment to be collaborative with service users taking account of
individual needs, combining targeted behavioural therapies and > Schema focused therapy PD / Disordered Eating Dual Diagnosis
Cygnet Nield House, Cheshire
interventions which lead to an increased post discharge quality of > Skills groups
life and functioning thus reducing the risk of relapse. Community Rehabilitation
> Social skills interventions Case Study
> Creative groups Map
Our multi-disciplinary team: > Mindfulness Service User Reviews
> Consultant Psychiatrist > Specifically for disorder eating: How to Make a Referral
> Psychologist • Enhanced Cognitive Behaviour
> Occupational Therapist Therapy (CBT-E)
> Dietitian • Specialist Supportive Clinical
Management (SSCM)
> Registered Mental Health Nurses (RMN)
> Registered General Nurse (RGN)
> Healthcare Support Workers
My mum is getting help at Nield house, it’s amazing!
We’re FaceTiming every day and me and my siblings
are seeing positive changes in her already and she’s
not even been there for a week yet. The therapeutic
activities you do are brilliant. The fact you have an
hairdressers within the facility is amazing.
- Family Member
23 | Personality Disorder Service Back NextGledholt Mews and Coach House, West Yorkshire Click the buttons to find
34 Greenhead Road, Huddersfield, West Yorkshire, Yorkshire & Humber HD1 4EZ out more about our
Personality Disorder Services
Community Rehabilitation
Introduction
18+ years Female 6 single occupancy self-contained flats Our Model of Care
Our myPath Care Model
Global Assessment of Progress
G ledholt Mews and Coach House is our service for adults community settings. The team consists of nurses, psychologist, (GAP) Outcomes
with mental health needs or a personality disorder who psychology assistants, occupational therapist, speech and Example DBT Pathway
have been able to progress through the hospital pathway and language therapists as well as 24/7 support from the nursing Outcomes
arelooking for the next stage in their rehabilitation journey. This team. This means that we are able to meet the changing Medium Secure
service has been designed around individuals from Kirklees needs of our residents as they progress through their care
Low Secure
in partnership with Kirklees CCG with the aim is to help these pathway, while ensuring their safety is maintained and their
individuals along their path towards independent living. independence supported. Tier 4 PD (NHSE)
PD Intensive Support
Residents are encouraged to cook independently (with or without Highly Specialised PD (CCG)
The service provides supported residential care to individuals who
staff support) in the Activities of Daily Living (ADL) kitchen or their
are ready to take responsibility for the continuation of their own PD / Disordered Eating Dual Diagnosis
own self-contained flats, however the kitchen staff are available
rehabilitation and recovery in a safe environment, whilst living in Community Rehabilitation
for assistance and to prepare meals in the large on-site kitchen.
the wider community.
Gledholt Mews and Coach House,
The service focuses on continuing practicing life skills and coping West Yorkshire
strategies. We concentrate on community based activities, the Case Study
use of public transport, education and vocational therapy, job Our facilities:
Map
placements, work experience and development of hobbies and > 6 personality disorder community rehabilitation Service User Reviews
interests. Located less than a mile away from Huddersfield Town self-contained flats, each featuring a lounge/diner,
centre with excellent transport links further afield, there are plenty kitchen and en-suite bedroom How to Make a Referral
of community based facilities nearby. For those individuals looking
for green space, there are a couple of options within a 5 minute > Garden with outdoor seating
walk, Greenhead Park and Gledholt Woods, popular for > Multi-faith room
relaxing walks.
> Activities of Daily Living (ADL) Kitchen
We have in-house MDT wrap around service that is designed to
support the individual in our care throughout their journey with > Dining room and lounge
us and is designed to capture and manage risk and relapse in > Activity room
> Tribunal / meeting room
> Assisted bathroom
24 | www.cygnethealth.co.uk Back NextCase Study
Em m a ’ s J o u r n ey * Click the buttons to find
out more about our
Personality Disorder Services
Introduction
Our Model of Care
Roseacre Ward at Cygnet Hospital Maidstone, Kent Our myPath Care Model
Global Assessment of Progress
Highly Specialised Personality Disorder Service for Women (GAP) Outcomes
Example DBT Pathway
Outcomes
Medium Secure
Emma’s history When Emma came to us When I came to Cygnet Low Secure
Maidstone I was detained under Tier 4 PD (NHSE)
Emma had a very difficult childhood, with When first admitted Emma struggled to
Section 3 of the Mental Health PD Intensive Support
an unstable family home she witnessed cease self-harming, needing additional
one-to-one care to keep safe. However,
Act and I had a very difficult Highly Specialised PD (CCG)
domestic abuse as well as alcoholism.
just two months into her admission, Emma start. I used to get angry a lot, PD / Disordered Eating Dual Diagnosis
Emma started deliberately self-harming had settled and was engaging in groups to self-harming, punching walls,
Community Rehabilitation
in her mid-teens, the same time that her help her tolerate distress. head-banging and ligaturing
Case Study
eating disorder took hold. In her twenties – anything I could do to get rid
Map
she suffered from domestic abuse We supported Emma to learn new ways of of the pain I felt emotionally.
from her partner for over eight years. coping where she was able to progress to Back then I didn’t know that’s Service User Reviews
Emma struggled to structure her time – groups which allowed her to develop skills what I was doing, it was just my How to Make a Referral
life consisted of working, going home in regulating emotions, with more general way of coping.
deliberately self-harming (DSH), uneasy skills in interpersonal effectiveness following.
sleep, and then returning again to work Mindfulness sessions formed the basis for the
the next day. impressive progress she made in the other
areas of the DBT programme.
After ten years’ intermittent contact with
psychiatric services, including an extended We took time to learn about Emma’s
period on a Psychiatric Intensive Care interests and arranged a personalised
Unit (PICU), Emma was in her early 30s gym programme and introduced other
when she was referred to Cygnet. She activities such as a Shop and Cook group,
was diagnosed with Emotionally Unstable to allow Emma to learn to choose a healthy
Personality Disorder (EUPD) and indications balanced diet.
that a significant element of her distress was
linked to post-traumatic stress. She spent At times, Emma experienced intense
eight months on acute and PICU wards in emotions which left her feeling unable
her most recent admission, but came to to cope and defeated. We gave Emma
us highly motivated to engage with the strategies to channel and express such
Dialectical Behaviour Therapy feelings and she was also able to explore
(DBT) programme. and change her relationship with
alcohol through the substance misuse
sessions provided.
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