The offering for service users at a Recovery College is being expanded after a successful first year in operation.
Heatherwood Court, a low security hospital offering treatment and rehabilitation for men and women on a forensic mental health pathway, launched its Recovery College in 2020.
The Recovery College offers service users a broad range of courses encouraging them to develop new skills to aid them in their recovery and to help with their return to the community. The college is co-managed by service users themselves, giving them an active role to play in its production and delivery, putting them at the heart of its success.
Becoming firmly established within its first 12 months, the team at Heatherwood Court – located near Cardiff and owned and managed by specialist healthcare provider, Ludlow Street Healthcare – have now developed a new prospectus with a wider course offering to reflect the requirements of service users.
Skills tutor Jenna Bayliss said: “Courses like English and maths have been really popular since the start because of their links to employability. We have had service users come to us unable to read or write and they leave able to do both. As well as being hugely rewarding for us as educators, this is invaluable to service users as they start to think about entering the job market.
“Of course, not everyone wants to focus on the educational side of things and the beauty of the Recovery College is that it is entirely catered to the individual, tapping into what people do want to know and what they think will be beneficial to their own future.
“Despite the restrictions of lockdown we were really pleased that almost half of service users attended the accredited education courses over the last 12 months.”
Service user Suz Yates was one of the original members of the Recovery College and now helps to run it. Suz believes that the key to the College’s success is the fact that it breaks down the boundaries between service users and staff, removing the ‘us and them’ culture and improves the self-esteem and confidence of the service users.
Suz said: “When they are hospitalised, service users often feel that they are de-skilled, de-personalised, separated from their usual support networks and find they can’t use their usual coping strategies. On top of that, policies and procedures in a standard hospital environment create an ‘us and them’ culture. The Recovery College helps dismantle these barriers.
“When I arrived at Heatherwood and discovered that a Recovery College was being set-up I was eager to play a role in its development as I was part of a Recovery College in my local community previously. It made a huge difference to my life; from personal knowledge I saw how it helped me gain self-confidence and increase my self-management skills.
“Without the divide between ‘staff’ and ‘patient’ I feel accepted and recognised as having intrinsic value to offer; an ‘expert by experience’.”
Royston Scott, Recovery College lead, said: “Now that the Recovery College is well established, we have a clearer idea of what service users find beneficial and what they want to see more of. We deliberately offer taster sessions that help people decide what will help them on their own journeys and this helps shape the prospectus too.
“We are so proud of the Recovery College team and the work they have undertaken to make the College such a success, they do a phenomenal job.”
HELP: Empowering people to live their best lives with pain
Think Therapy 1st discuss their pioneering results-based pain management programme
Through the launch of the Holistic Education for Living with Pain (HELP) programme, Think Therapy 1st is helping to give new hope to people living with pain. NR Times learns more about the first-of-its-kind initiative which is set to change the lives of countless people who too often suffer in silence
While pain is something that is all too often dismissed, leaving people struggling to manage their daily lives with few places to turn for practical support, for Think Therapy 1st (TT1st) comes the opportunity to use their expertise to make a life-changing difference.
As pioneers of a pain management programme which saw 100 per cent of participants report improved functioning as a result, and vast decreases in the level of pain in daily activities such as socialising – where the pain rating reduced from an average of 7.6/10 pre-programme to 2.6/10 afterwards – the team wanted to create an even more compelling offering for those in need of bespoke support.
While the initial pain programme was an occupational therapy (OT) only project, now, with the launch of the Holistic Education for Living with Pain (HELP) programme, TT1st have extended their MDT to include psychologists and physiotherapists.
A unique programme in the field of pain, HELP is delivered on a one-to-one basis over a four-to-six month period, and importantly is delivered in a person’s own everyday environments.
Participants are empowered to live their lives through the power of education, with the onus on the activities and tasks they can do, rather than what their pain has restricted them from, re-opening the possibility of returning to leisure, work or the employment market.
And while TT1st does not make any claims to reduce levels of pain through HELP, the vast majority of participants do experience a reduction in pain as a result of their involvement.
For Helen Merfield, managing director of TT1st, the expansion of the initial pain programme is a welcome opportunity to tackle the issue of pain in new and impactful ways.
“We got awesome results from the programme, but we could only help a small cohort. We felt we needed to reach out to more people with a wider spectrum of conditions, pain is something I feel very passionately about and people need support,” she says.
“I’ve always felt that people with pain get a bad rap, they’re often just told it’s all in their mind. And while the mind might play a part, no one consciously chooses to be in pain, they don’t get up in the morning and decide ‘I’m going to have pain today’.
“We want people to be living their best lives in spite of – or as I like to say ‘to spite’ – their pain. We HELP them to recover a life that has meaning and purpose.
“We wanted to help a wider population but wanted to test it on a smaller scale first. And because the results were so great, we have invested in making it even better – and hopefully the results will be even better too.”
Leading the HELP programme, which launched earlier this month, is Steph Fleet, a pain specialist OT who joined TT1st in 2020 and who Helen credits with “taking the bull by the horns” in breathing new life into the company’s pain offering.
Through adding in psychology, with TT1st working alongside neuropsychology specialists at Sphere Rehab, HELP is bringing together experts in their field to deliver the best possible results to clients.
Dr Katherine Dawson, director at Sphere, said: “Partnering together in the development of a stepped care functional model to inform when therapy is indicated (as well as identifying different levels of intensity) is a great opportunity to deliver positive client experiences and outcomes.
“We are also really looking forward to exploring how technology can help with early interventions in the functional management of pain.”
Under Steph’s guidance, HELP has been created to be tailored to the needs of each client. If psychology input is required, their needs are determined through the use of a newly-developed algorithm by Sphere.
Clients will be screened at the assessment to determine which mix of disciplines they require, OT only, OT and physiotherapy, OT and psychology or all three.
With a fixed fee pricing structure, HELP can be completed in a timescale to suit the needs of each individual client, with a specially-designed workbook and a raft of resources – including podcasts and video – to support them through the process.
“Pain is something that doesn’t get talked about like it should, I feel really strongly for anyone experiencing any level of pain that unless you talk about it and develop some strategies, then it’s just going to keep continuing and holding you back,” says Steph, who won the rising star accolade at the Advancing Healthcare Awards 2022 in recognition of her client-focused work.
“They’re going to learn how to manage their pain, so that they’re able to do the things that they need to do, but also the things that they want to do, despite their pain experience. They will learn lots of techniques and develop tools to do that.
“We wanted to create a programme that was flexible and exactly what people want and need, and already, although HELP is new, we are seeing some brilliant results.
“I’ve got a client who’d been standing in an almost brace-like position, her knees and back have been bent, as if she’s about to run.
“The physical reason for this position had resolved, so we talked about it in terms of her brain being hyper-alert to danger, therefore she was defaulting into this position essentially being ready to run.
“I helped her see she no longer needed to be ready to run and the danger had passed and it was safe to straighten up.
“She has done that for a week and her pain experience has dropped massively, because she’s standing in the right position again and recognising that she’s not in imminent danger.
“So that conversation, and the strategies we came up with, have enabled her to see positive change.”
The client, Juliet from Dorset, said: “The key thing I’ve been taking away to help me when Steph’s not with me is becoming aware of my standing position.
“I’m telling myself that I can stand up straight and I recognise that I’ve been locked in my traumatic experience. I’m now much more aware which has helped me to progress.
“Improvements are being made and my perception of pain has reduced a lot”.
Helen continues: “It’s all about tailor-making it for everyone.
“Although there are fixed components, there are more components than required because not everyone will need everything. Some people will need more of one type of support than another.
“But what we see is that because it’s tailored, they start seeing improvement almost from day one, there’s so much education involved that we are teaching them to be their own therapist, putting them back in charge of their pain experience rather than it running their life.”
One big difference to other pain management programmes is the delivery in a participant’s own environment, be that their home or places they spend time or need to access.
“The majority of current programmes on offer are great, but they’re not delivered in an environment where people are actually living their lives, they’re often in a a completely different environment,” says Helen.
“While people may get a solid two or three weeks to focus solely on education and therapy, they leave and have to come back to real life. The programme finishes and they just go home. They’ve learnt all of this information, but how do you actually apply that when you’ve got a family, kids, a dog running around?
“What you thought could transfer quite easily because it all made total sense when you were on the course now goes out of the window, and you find that within three or four months they’re back to where they were before.
“That’s why delivering it in a person’s own environment, with all of their daily routines and tasks around them, is so important. So that even after
we leave them, when they have a new environment, whether it’s a new job, they’ve moved house or they’re just going to a different cafe, they’ve got the tools they need in their toolkit to keep them safe in that environment.”
Steph adds: “HELP is also unique when compared to others which are in a group setting. There’s nothing wrong with a group session, but this makes it so individualised and so accessible for the person.”
“And then we take the education and learning we have delivered and we put it into practice, with support from an OT, physio or psychologist, depending on what they need. We’re going to do it with them, in their environments with the world happening around them and model it with them, which is why we get such great results.”
And with such a pioneering programme to work with, Steph, who has a Masters in rehabilitation, is delighted to have the opportunity through TT1st to make a difference.
“All the clients I’ve worked with over the years have experienced pain to some degree, whether that’s psychological pain or physical pain,” says Steph.
“And I’ve always found it really interesting how it can really limit people’s abilities and last longer than many of the physical challenges they manage to overcome.
“Rehabilitation is my absolute passion but pain kept on coming back as something that affected so many people and doesn’t get talked about. The individual often feels that it’s their fault – and then I came to TT1st and had the opportunity to really jump into helping them.”
Chroma supporting schools with mental health and creativity
Chroma is implementing arts therapies into schools, supporting children through collaboration with teachers
Arts therapies provider Chroma is implementing arts therapies into schools to help support children’s mental health, creativity and resilience through collaboration with teachers.
Based on experiences working within schools in Beijing, Bangkok and Singapore, learning consultant Nici Foote believes that creativity and collaborative teaching and learning experiences motivates students to think critically, help them with authentic problem solving, and provide students with greater opportunities to use higher-order thinking skills to support understanding.
“Children were more engaged and tuned in through an inquiry learning process,” she said.
“The Primary Years Program, sees students follow their own ideas, researching and undertaking different activities around the classroom to get children activating their own choice and voice within learning.
“In Singapore, Bangkok and Beijing, the schools are forward thinking and innovative. They use the Inquiry Process, whereby students lead the way in their own learning journey.
“Collaboration between teachers and students, within lessons, offers an innovative approach to education that helps build and create ‘trust’ between all parties. Supporting students creatively, helps steer them towards gaining a better understanding of a topic or subject.”
Chroma aim to implement arts therapies into schools to achieve similar effects for students.
Daniel Thomas, managing director at Chroma, said: “Arts therapy sessions implemented within schools will help support children in self-expression and build self-confidence, both of which have become even more important factors due to the mounting pressures children face at school.
“Role-play in dramatherapy, for example, can help students explore issues they may be dealing with within school or at home; art therapy activities support self-expression allowing children to discuss their feelings and music therapy develops confidence, helps develop healthy bonds between students and teachers, and facilitates positive changes in emotional wellbeing.
“Above all else – these sessions are fun and provide students with a necessary pause from schoolwork. Following arts therapies sessions, children feel motivated and inspired, creating a positive attitude towards the rest of the school day.
“Teachers are also encouraged to participate in sessions, to help build trust between teacher and student and to gain a better understanding of their students’ emotional wellbeing and needs. With this, teachers can identify the ways in which they could change their approach to teaching to help facilitate a more amiable learning experience – one that is vibrant, passionate, student-focussed and where all students can thrive.
“Teachers, mentors, teaching assistants and arts therapists should work together and support students’ learning journey to help children develop resilience in a supportive environment – where they can learn without a fear of failure.”
Nici adds: “In order to be a great teacher, you need to consider yourself a facilitator. Changing the language of teaching is the first step.”
Arts therapies promote creativity, collaboration and innovation between teachers and students, which when applied towards learning outcomes, could offer teachers the opportunity to teach innovatively and students to learn – creatively.
How visualisation can support emotional wellbeing
Chroma assess how guided visualisation can enable clients to overcome mental and emotional challenges
Imagination may hold the key to improved quality of life as it can help alter perceptions of difficult issues in a positive way.
Chroma Dramatherapist and mindfulness practitioner Katy Weston implements guided visualisation into her sessions, in essentially the same way – allowing clients to ‘play’ in ways they may not be able to in everyday life, for instance, if they are cognitively and/or functionally impaired.
Katy finds cards with images help guide sessions, as she can determine which image resonates with a client that day, for example, a boat, tree or plane, and steer the session from there.
“I have a client who suffered a catastrophic brain injury. I use cards for guided visualisation in our sessions to determine if there is a story we can make up from it and discuss the image,” she says.
“For instance, if the client chooses ‘the sea’, I ask ‘Are we swimming? Are there dolphins?’ From there I will jump into the water and ask her if I can hold the client’s arm to imitate swimming (I will always ask a client so they know they have control of what is happening).
“Movement is encouraged during our sessions where possible, and from there, we can swim with dolphins and venture on a journey together.”
Guided visualisation follows the theory that ‘if you can see it, you can feel it’. It has the ability to transport the mind to the idea of alternate possibilities – where you can escape your own reality – even if it’s just for that moment.
With guided visualisation, it is possible to gain a new perspective on a particular issue, condition or life moment, which may be difficult to come to terms with.
Katy recalls a client in palliative care who described herself as ‘sitting in a waiting room merely waiting for death’.
Through guided visualisation, the client was able to draw the room, its windows, its doors, plants, reading material and so on.
Staff commented that following that session, the client was like a different person – approachable and talkative. She allowed people into her room to chat. Following the initial session, she continued to imagine doors and paint them.
In the client’s own words, she said she now ‘felt in control to make this experience different’. She felt empowered.
Guided visualisation, part of Chroma’s portfolio of arts therapies, allows people to explore issues in a safe way, which helps create an unconscious shift that can present the client with a different perception on an event and help them overcome the mental and emotional issues surrounding them.
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