The primary task of the staff is to 'be with' and be alongside the clients in their distress, in as non-intrusive way as possible.

THE THERAPEUTIC COMMUNITY

Stabilising clients

CHT’s therapeutic programme is designed to create a structure that will lead to stabilisation for its clients. The establishment of set rules and timetables creates an environment where trust and safety can be developed.  

Each member is drawn into the life of the community by becoming involved in the key decisions which affect the household. Clients discuss their difficulties and feelings in groups, exploring the repetitive patterns of disturbed thoughts and behaviours, patterns which keep them from constructively fulfilling their true potential.  

Boundaries and rules for clients

It is extremely important in a therapeutic community that boundaries and rules are consistently and clearly reinforced. Staff do this not just by repeating the rules but by also demonstrating the ways in whch respecting the boundaries is also showing a respect for self and others in the social context.  

Groups and their structure

The therapeutic programme is made up of a number of different groups. Community Meetings (where all staff and residents are encourgaged to come togther to make decisions effecting the house), Psychotherapy groups (for personal exploration), and task orientated groups (e.g. cooking, cleaning, shopping, and gardening). 

Supervising medication

Interdisciplinary work is important as it enables a more holistic view in which medication and psychotherapy are used together. CHT staff work in close cooperation with each client's psychiatrist in pharmacological treatment programmes. Staff facilitate a culture that encourages the open discussion of the effects and side effects of psychiatric medication. Issues are brought up for discussion and negotiation with the consultant psychiatrist in regular reviews and gradually, over time, reductions in medication can often be achieved.

The length of stay

The length of stay for each client varies according to individual needs and the progress of their therapy. However, the rehabilitative direction of the therapy is always aimed at social inclusion and developing the skills necessary for each client to build and maintain a network of relationships in the community. Move-on planning begins, therefore, immediately on admission and forms an element in regular reviews. In some cases CHT therapists are able to offer a level of continued therapeutic engagement with clients for a while following their discharge. And some, who may need further support and psychotherapy, move into one of our step-down flats.

 Step-down flats

CHT Supported Living Flats offer single person self-contained accommodation with psychotherapeutic and practical support for previous users of CHT residential care services and for those who are not considered to require the higher level of support that our residential care services provide.

As part of a need-adapted and phase-specific treatment we aim to provide an experience of supported living for our clients, without the loneliness and social isolation which often accompanies it and which can lead to social withdrawal, consequent deterioration and re-admission to hospital. As well as individual psychotherapy the project also offers supportive therapeutic groups, and assistance in maintaining strategies for community inclusion, meaningful daily activities and developing social networks. This model of support continues the ethos of CHT which sees interdependence, rather than independence, as essential in a meaningful life.