Aspire Care LAL
Aspire Care LAL

Psychology Model

We aspire to embed a therapeutic culture within our homes by adopting a clinically effective treatment approach integrating principles from evidence-based models of therapy. The predominant psychological model adopted across Aspire Care is Dialectical Behaviour Therapy (DBT).  

DBT is an intervention recommended by the National Institute for Clinical Excellence (NICE) for working with those struggling with a number of complex mental health and personality difficulties, including those diagnosed with Emotionally Unstable Personality Disorder (also known as Borderline Personality Disorder). The approach is also thought to be useful to help those struggling with issues relating to: self-harm; substance misuse; eating; autistic spectrum conditions and; post traumatic stress (PTSD).

 

In line with this model we also ensure our staff are trained in principles of attachment and use reparenting approaches to support our young people compassionately.

 

Our goal is to ensure that each individual works through four stages during their participation in the programme:  

  1. Establishing behavioural control by reducing their life threatening behaviours and behaviours that challenge others.
  2. Emotional experiencing through reducing symptoms of traumatic stress and associated problems such as self-blame and avoidance of feared places, activities and experiences.
  3. Ordinary unhappiness. The goal of this stage is to learn how to solve problems of everyday living and increase joy and happiness in life.
  4. Developing a capacity for joy. At this final stage, we work to help young people consolidate their learning and begin to plan for transitions into more independent lives.

 

 

 

Our view is that therapy can be most effective when it is delivered through a range of different ‘modes’ supporting both the service user but also the team of staff working with them. We make sure we provide weekly group therapy, individual therapy, 24-hour-a-day individual coaching and weekly staff consultation.

The four core areas focused on in the therapy programme include:

  •  Core mindfulness (living in-the-moment)
  •  Emotion regulation (staying healthy/increasing positive activity)
  •  Distress tolerance (managing in times of crisis)
  •  Interpersonal effectiveness  (relationships with others)

 

Our therapy staff

We have a consulting Clinical Psychologist, a Trainee Psychologist and a number of Therapeutic Care Advisors working across the service. All staff supporting the therapy programme meet regularly for team consultation to consider how to deliver the best quality of care for each young person. As such, all staff are trained, clinically supervised and have a psychological understanding of the individual problems faced by the young people in our care. All staff have training in complex mental health issues and DBT. 

Outcomes monitoring

We measure and report change through a number of understandable measures of outcome that consider risk and reduction in problem behaviours, life functioning, general wellbeing, progress towards individual goals, and occupational engagement. All our outcomes are based on the core domains of the Young Person’s STAR and the reduction of behaviours the individual and their therapist identifies for targeting:

 

 

 

 

 

Length of placement

While it is not always possible to secure long term placements for young people, we ask that they and their funder commit to a minimum of one cycle of the group programme. Depending on when they enter into the programme, this will be approximately 25 weeks, or 6 months. We arrange a CPA review after every three months to consider the progress each young person is making and how to best meet their needs going forward.