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THE HUB DAY PROGRAMME. GRAMPIAN SPECIALIST PSYCHOTHERAPY SERVICE ABERDEEN. Upper Garden Villa Royal Cornhill Hospital 01224 557398. Who Are We?. Who Is Referred To The Hub Day?. Assessment Childhood Trauma Questionnaire (CTQ) Personality Questionnaire (PDQ4) BPD traits/diagnosis

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Presentation Transcript
slide1
THE HUB DAY PROGRAMME

GRAMPIAN SPECIALIST

PSYCHOTHERAPY SERVICE

ABERDEEN

Upper Garden Villa

Royal Cornhill Hospital

01224 557398

who is referred to the hub day
Who Is Referred To The Hub Day?

Assessment

  • Childhood Trauma Questionnaire (CTQ)
  • Personality Questionnaire (PDQ4)
  • BPD traits/diagnosis

MBT formulation

  • Understanding effects of past on the present. Not to re-live it.
  • Set goals, plan for the future.
  • Recover a sense of agency.
pre hub meeting
Pre-HUB Meeting
  • Informal 20-30 mins.
  • Meet staff
  • Department Tour
  • Discuss Anxieties
  • Hub leaflet
  • SCL90
  • Talk about formulation / goals
hub day programme
HUB DAY PROGRAMME

24 weeks

Business Meeting

Morning Group 8 weeks MBT Education

8 weeks SCID 11

8 weeks Mentalization Based Skills

Lunch Time 12.15-13.30

Afternoon Group Mentalization Based Therapy (MBT)

business meeting
Business Meeting
  • Not a Therapy Group
  • Lasts up to 15 mins
  • Brings 2 groups together
  • All Hub staff attend
  • Any Messages
  • Already adopting an MBT stance
  • Enforces a pro-social and relational approach.
mbt education morning group weeks 1 8
MBT Education (Morning Group Weeks 1-8)

Week 1 Contracts & Rules of Engagement

Week 2 Mentalization Based Therapy

Week 3 Mentalization and Attachment

Week 4 Emotional Awareness

Week 5 My Intervention Plan

Week 6 Personality

Week 7 Looking after Yourself

Week 8 Communication

s c i d d ii morning group weeks 9 16
S.C.I.D.D. II(Morning Group Weeks 9 -16)
  • Structured Clinical Interview for DSM-IV AxisII Personality Disorders (SCIDD – II)
  • Diagnostic questionnaire
  • Mentaliszing Exercise in group
  • Develops the idea of ‘Thinking about thinking’
  • Considers feeling states in self and others
  • Related behaviours and thoughts.
mbt skills morning group weeks 17 24
MBT SKILLS(Morning Group Weeks 17 – 24)
  • Mentalizing Based Skills
  • Developed from MBT exercises.
  • Thinking about future
  • Managing endings
  • Goals re-examined
  • What next?
  • Can be patient-led
lunch time
Lunch Time
  • Challenge patients views on social interactions
  • ‘Have a go’
  • Can be material to use in the afternoon.
  • Light hearted, fun, staff join in.
  • Last days can be marked by a picnic/cakes.
afternoon mbt group
Afternoon MBT Group
  • Runs every afternoon for full 24 weeks.
  • 1 1/2 hours long

Aims

To provide a training environment for mentalizing -

In self

In Others

In Relationships

what is mentalization
What is Mentalization?
  • Understanding misunderstanding
  • To see ourselves from the outside and others from the inside
  • Shapes our understanding of others and ourselves
  • Central to human communication and relationships
  • Underpins clinical understanding, the therapeutic relationship and therapeutic change regardless of modality of therapy
mentalization based therapy mbt
Mentalization Based Therapy(MBT)
  • Aims to strengthen patients capacity to understand their own and others mental states in attachment contexts in order to address difficulties with -
    • Affect regulation
    • Impulse regulation
    • Interpersonal functioning

All of which contribute to suicide and self harm.

Bateman and Fonagy 2009

group mbt
Group MBT
  • Non – mentalizing patients + (we hope) mentalizing therapist
  • Based in the here and now
  • Current issues
  • Actively promote group interaction
  • Intervene when there is an opportunity fro metalizing
group mbt cont
Group MBT cont ...
  • Not waiting to see ‘how the group deals with it’
  • Open questions
  • Curiosity
  • Stop Rewind Explore
  • Simple
  • Affect focused but remember most reactions are about survival
  • Focus on patients mind (not on behaviour)
what group mbt is not
What Group MBT is not...
  • A support group
  • Transference relationships
  • Metaphor
  • Interpretation
inbetween the hub
Inbetween the ‘HUB’
  • Not an out of hours service.
  • Patients encouraged to use crisis plans
  • Encourage to think about their original formulation goals and what they hope to achieve from the hub.
  • On model to make contact in-between hubs if the patient hasn't made contact.
mbt supervision
MBT Supervision

MBT Adherence Scale

Straight after HUB programme ends

All therapists from the day attend

post hub interview
Post Hub Interview
  • Thinking about the ending is part of the MBT work in the last weeks of therapy.
  • 6-8 week allowed before follow-up
  • Allows time to process work done
  • Can feel rejected and abandoned
  • Individual review appointment offered to discuss future.
research
Research

Ongoing

Pre and Post HUB - SCL90’s

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