Clinical Information

The CHT Model

CHT uses a unique clinical model to enable people experiencing severe mental and emotional distress – including psychosis and personality disorders, and with complex presentations such as self-harm, suicidal preoccupation, delusions, dependencies etc – to achieve more of their potential and to fulfil more of their aspirations in life.

Our model is derived from theory and practice in Therapeutic Communities, Psychodynamic Psychotherapy, Psychologically Informed Environments (PIEs), the Recovery Approach, and the latest perspectives from relational neurobiology, to create a participative and democratic recovery approach.

We believe that the most significant component of the development of mental disorders of any kind is damaged developmental processes and damaging early (and often ongoing) relationships (Felitti et al, 1998*; van der Kolk, 2005*). We provide individually tailored programmes for each of our residents to enable individual psychological, emotional and social development through individual psychotherapy and keyworking, individual, small and large group activities, and a residential community living-learning experience.

 

Measuring outcomes

In order to evaluate the effectiveness of our model, we need to measure the changes that our residents experience.

CHT is committed to providing high quality, effective services and to systematically monitoring clinical outcomes. CHT currently utilise:

Honos – measures the mental health and social functioning of people using our services

CORE-OM – A self report tool which measures the level of current psychological global distress in four areas:

  • Subjective well-being
  • Problems/symptoms
  • Life functioning
  • Risk/harm

Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) – A self report tool which measures mental well being

CHT also systematically monitors engagement in activities, move-on outcomes, and client feedback – ‘real’ outcomes in changes in people’s lives.

By monitoring outcomes, we can evaluate the effectiveness of our work.

On admission to our communities, people’s Honos and CORE scores are above the average for people entering psychiatric admission wards. Despite this, in the last year 67% moved on to low support or independent accommodation, 26% were engaged in education, training, voluntary work or other such meaningful external activities, and 11% were in paid employment.

 

Further reading on theory and practice

CHT’s approach combines four evidence-based approaches to create a holistic developmental framework. Information on these approaches can be found in the following sources:

PIE
Cockersell P, (2016), PIE: Five Years On, in Mental Health and Social Inclusion, 20:4 p221-230
Cockersell P, ed., (2018), Social Exclusion, Compound Trauma and Recovery, London: Jessica Kingsley Publishers

Therapeutic Communities
Pearce S & Haigh R, (2017), Theory and Practice of Democratic Therapeutic Community Treatment, London: Jessica Kingsley Publishers

Psychodynamic Psychotherapy
Caligor E, Kernberg O, Clarkin J & Yeomans F, (2018), Psychodynamic Therapy for Personality Pathology: Treating Self and Interpersonal Functioning, New York: American Psychiatric Association Publishing
Shedler J, (2010), The Efficacy of Psychodynamic Psychotherapy, in American Psychologist, 65:2, p98-109
Solms M, (2018), Scientific Standing of Psychoanalysis, in BJPsych International, 15:2, p5-8

Interpersonal Neurobiology
Porges S, (2013), The Polyvagal Theory, London: Norton
Schore A, (2013), The Science of the Art of Psychotherapy, London: Norton

Recovery
Shepherd G et al. 2008, Making Recovery a Reality, accessible at https://www.centreformentalhealth.org.uk/publications/making-recovery-reality
Slade M, (2015), Empirical Evidence for Recovery and Mental Health, in BMC Psychiatry, 15:285, p2-14

 

*Felitti V J, Anda R F, Nordenberg D, Williamson D F, Spitz A M, Edwards V, Koss M P (1998), The relationship of adult health status to childhood abuse and household dysfunction in American Journal of Preventive Medicine 14:245-258.

*Van der Kolk B, (2005), Developmental Trauma Disorder, in Psychiatric Annals, 35:5, p401-408