Model of Care

Care in Mind offers therapeutic mental health support packages for young people and young adults who have a range of complex mental health difficulties. As such, their needs are different and various. However, we believe that there are a number of therapeutic principles that need to apply to our work with these young people irrespective of their presentation.

Click on the elements to view the stages of our approach.

1. Promoting Safety
2. Enhancing Attachment
3. Therapeutic Work
4. Facilitating Recovery

1. Promoting Safety

Many of the individuals with whom we work have very complex histories. They may have experienced the world as an unsafe place. These experiences and behaviours can leave young people feeling emotionally and physically ‘unsafe’. Before any more profound psychological progress can be made, they need to have an experience of being able to be kept safe.

Care in Mind work to ensure that measures are taken to create a sense of emotional ‘safety’ for an individual by promoting their confidence in and relationship with all those involved in their care.

Care in Mind provides specialised training and consultation to assist teams in developing the skills required to work in this way. We also facilitate ‘staff support’ groups to support staff teams. Care in Mind works closely with care teams and clients to develop joint care plans that incorporate detailed information about triggers and early warning signs as well as coping strategies that can assist in effective pre-emptive management.

2. Enhancing Attachment

As clients begin to experience a ‘carer’ as someone who is able to help them to stay safe, trust begins to form. This trust is fragile at first and perceived inconsistencies may lead to a re-emergence of old patterns of behaviour. Initially, the individual may feel the need to ‘challenge’ the carer with extreme behaviour to test the resilience of the relationship.

Care in Mind will provide support for the team during this period, fostering a culture of reflection within the team, so that they can better understand the reasons for the presenting behaviours. In time, relationships with carers can help a person to develop a new unconscious ‘internal model’ of how a relationship with a trusted carer should be. CiM try to help the team build the skills to provide a consistent, nurturing yet boundaried approach  that helps clients to develop good attachment relationships.

Clearly, it is more ‘natural’ for an individual or couple, such as foster or adoptive parents, to provide such a model of ‘normalised’ parental attachment.  However,  for some of the more complex and risky individuals with whom we work, the intensity and pressure that the work would place on any one individual or couple would be overwhelming – which would be likely to lead to the failure of the placement.  This then becomes another rejection for the client. For this reason, the most complex individuals are often best initially placed in residential care homes.  We will always consider the possibility of a move onto foster care at a later date where appropriate.

3. Therapeutic Work

Once a client begins to feel emotionally safe, they now have the ‘secure base’ to begin to make sense of their emotions, symptoms and past experiences and to work toward an alternative and positive future.

Care in Mind has clinical psychologists and psychotherapists who are able to offer a variety of approaches in individual psychological therapy, group work and family therapy and art therapy. We will tailor our therapeutic approach to the individual needs of the individual client, in regard to the frequency of sessions, the model of therapy employed and the duration of the work.

4. Facilitating Recovery

It is important to begin the process of looking forward and preparing a client for their future lives from the beginning of their placement. However it can also be very frightening in the initial phase of their placement to ask them to think about the future or to  expect them to be able to function independently.

Usually it is important to begin with programmes which enhance life skills, but within a very well supported context, which does not force ‘independence’ on an individual who may be functioning emotionally at the level of a younger child and may have a strong emotional need at this moment in time to feel  ‘looked after’ by trusted adults.

The Care in Mind team can help residential teams reflect on these issues and develop life skills programmes that meet both the practical and emotional needs of those in their care. We have extensive expertise of supporting individuals into placements who have previously spent extended periods in mental health hospitals or secure settings. There is often a need to provide a very structured and supported environment initially, with very gradual steps toward greater independence.

This can be important in gently reducing a client’s ‘institutionalisation’, without overwhelming them in their new setting. Progressing too fast in this regard can lead to a sense of panic and fear, which may lead to an escalation in symptoms. If done in a sensitive manner, a client will make gradual progress with their independence and life skills to be able to move forward at their own pace. As they progress, Care in Mind will work with carers to plan future steps.

In cases where there is a clear need for an on-going level of support when an individual is leaving care, it is important to plan very gradual transitions. Care in Mind has had great success in providing bespoke transition packages into independent tenancies with gradually reducing levels of support, so as to assist a client to work toward fully independent living.