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Personality Disorder Therapeutic Environment

The Acorn Unit is a therapeutic environment for women meeting the criteria for:

  • Borderline Personality Disorder
  • Dissociative Disorder
  • Complex Post Traumatic Stress Disorder

We are incredibly proud of The Acorn Programme which was first accredited as a Therapeutic Community by the Royal College of Psychiatrists through the Community of Communities in 2007 and of the hard work and progress made by the clients who have graduated. We were also winner of the Specialist Provider of the Year at the 2014 Independent Healthcare Apex Awards.

We continue to work successfully with women who have recurring, acute inpatient admissions or self-defeating behaviours that result in chaotic lifestyles.

What is a Therapeutic Environment?

The aim of a Therapeutic Environment is to provide a safe environment that enpowers women to work together to manage their distress and enable them to embark upon a more stable and meaningful life in the community. We have a strong focus on occupational engagement and are proud to support and inspire our clients in their pursuit of meaningful occupation.

An important part of the treatment is for women to share their daily life with others and to take responsibility for sharing decisions about how to live together. Our staff set the overall structure of the programme, clients are asked to contribute to keeping the treatment safe and therapeutic, both by acting responsibly themselves and by helping others think about the effect of their behaviour on the unit.

We encourage a ‘culture of enquiry’ in which everyone can question the conduct of any other individual or group of individuals, psychological processes (‘I wonder what made you do that’), and managerial issues. Such questioning is an important learning opportunity, for those asking the questions and for those questioned.

Everything that happens in the community is open for discussion. We have a principle: ‘if you have a secret, you have a problem’. For many people the letting go of the need to keep parts of their lives hidden is a major part of their therapy.

Most of the structured work of the group is built around developing strategies and skills to handle the demands of daily life, using a plan of treatment called Dialectical Behaviour Therapy (DBT). The National Institute for Health and Care Excellence (NICE) particularly recommends DBT for women with BPD who want to reduce self-harming and suicidality.

Our Approach

We treat the person not the diagnosis and our mantra is simple: Turn up, Tune in and Tell the Truth.

On arrival at Acorn our clients start an important journey that will last 8 to 12 months. During their time with us they will acquire the skills they need to live in the community and manage their distress so they are able to engage in a meaningful life worth living.

This is achieved by:

  • Phase 1 Our clients learn DBT skills to enable them to manage emotional response around trauma
  • Phase 2 Our clients engage in trauma work to enable them to work through issues and find a way of stopping self-defeating behaviours
  • Occupational Engagement Participating in our occupational engagement programme: We offer life skills sessions designed to help the client prepare for their return to a meaningful life in the community which are tailored to the person's needs. We also encourage trips to cafes, train stations and town centres as well as arranging volunteer work in the community. In fact, clients have taken University courses during their time with us.

The Team

The team includes registered mental health nurses, a Consultant Psychiatrist, a Consultant Clinical Psychologist, and an Occupational Therapist, as well as input from other professionals such as a Social Worker, an Involvement Worker, a Dietitian, and sessional therapists for art and other creative therapies. The team members are all trained in DBT to varying levels and are experienced in working therapeutically with this client group.

Interventions provided:

  • Dialectical Behaviour Therapy
  • Family work
  • Life skills
  • Group analytic work
  • Individual psychotherapy
  • Dietetics
  • Occupational Therapy
  • Creative Therapies

Outcomes 

  • Improved quality of life
  • Reduction in self harm
  • Reduction in inpatient admissions
  • Reduction in dissociation
  • Improved ability to manage emotions
  • Improved healthy relationships

For further information or to make a referral please call Amy Bedingham on 01904 420910 or email info@theretreatyork.org.uk.

Eligibility Criteria

  • Meet the diagnostic criteria for either:
    • Personality Disorder
    • Complex Post Traumatic Stress Disorder
    • Dissociative Identity Disorder
  • Working age females.
  • Informal and Formal (must be able to work towards being informal before admission in order to fully engage with the programme).
  • Motivation to change; willingness to engage in group programme and therapy.
  • Has a Care Co-ordinator from the Community Mental Health Team (CMHT).

 Exclusion Criteria

  • Psychotic disorders
  • BMI below 17
  • Moderate to severe Learning Disabilities

 

 

 

Useful Documents