Moorgreen service provides pathway to recovery
The care funding crisis has led to a nationwide shortage of specialist mental health support, but Heathcotes have forged a pathway to success with a service near Nottingham which is helping people with personality disorders.
Heathcotes Group opened our Moorgreen Specialist Residential Treatment Service in Hucknall to provide treatment for people with a diagnosis of Emotionally Unstable Personality Disorder (EUPD), a complex condition which is estimated to affect up to 1.3 million people in the UK. It often involves very intense emotions and feelings of abandonment and loneliness which can result in difficulties in establishing stable relationships, impulsive acts, self-harm, life-threatening behaviour and admission to secure hospital accommodation.
Successful treatment is extremely challenging but Heathcotes have used a therapy programme which helps residents to understand their feelings and teaches them skills to manage their emotions and behaviour with a transition into more independent living as the ultimate goal. The service recently celebrated its latest successful transition when, a year after arriving at Moorgreen, SM moved out to one of Heathcotes’ independent support living apartments. She was the second Moorgreen resident in as many weeks to complete her ‘graduation,’ this is a term used in Dialectical Behaviour Therapy to reflect the learning process involved in recovery.
SM was admitted to a secure hospital in 2014 and remained there for over two years. She was then referred to Moorgreen and began Dialectical Behaviour Therapy (DBT). This is a therapy that was developed by Marsha Linehan to help people with Borderline or Emotionally Unstable Personality Disorder. It includes a combination of one-to-one therapy a skills group, and opportunities for skills coaching between sessions. This has helped SM to learn different ways to regulate her emotions without using problem behaviours. The therapy includes modules in mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness. The service that Heathcotes offers is unusual as it is a Specialist Residential Treatment Service that offers full programme DBT within a residential home. This enables the skills learnt in therapy sessions to be reinforced in the day-to-day life of Moorgreen’s residential environment. Here the service is designed to support the skills learnt in the group to be generalised into the home and into the community. All the support staff have specific training in working with people with EUPD and they have an understanding of DBT and the skills that are taught. The Specialist Residential Treatment Service was developed by Dr Peter Burbidge (Consultant Clinical Psychologist) and Cathy Conway (Specialist Occupational Therapist and DBT Therapist). Peter and Cathy are both specialists in working with people with EUPD.
SM described her journey:
“I had lots of problem behaviours after I moved in but I started doing the therapy. I found the therapy really hard because I was struggling with my own problems and often felt like quitting - without the help from Pete and Cathy, I don't know where I would have been. Then I started using the skills and things started to get a little bit easier. I began to reduce my problem behaviour and I started engaging more with the staff and telling the manager of Moorgreen how I felt. These things really helped my progress. I never thought I would get to a point in my life where I have been four months incident-free. This is a huge achievement for me and I did it by setting myself some goals and taking baby steps to get there through using the DBT Therapy.”
Nearly half of all people diagnosed with a personality disorder are given a diagnosis of Emotionally Unstable Personality Disorder, also known as Borderline Personality Disorder, and around three quarters of these are women. A key aspect of the therapy at Moorgreen is helping service users to gain a better awareness and understanding of their emotions as well as the confidence to talk about them and the skills required to regulate them. SM now has a strong understanding of those skills. She became a senior member of group and ending up running some of the Mindfulness exercises.
Cathy Conway commented on SM’s graduation:
“SM is a caring and compassionate person who enjoys the learning environment and wants to support others in their DBT journey. We are all very proud of the hard work SM has put into her DBT programme and the progress she has made. She has completed a lot of courses at the local NHS Recovery College and continues to attend others. I know that SM also has plans to get involved in other community groups and voluntary work.”
It is fantastic to see and this is the kind of outcome which Heathcotes strive for at Moorgreen. We believe that a major part of our success is in extending the therapy, the skills and the DBT language into the home so that the learning is assimilated into the everyday lives of the residents and staff.”