The Adults Programme

WHAT KIND OF THERAPY DOES RESPOND PROVIDE?

Respond provides psychodynamic psychotherapy. We have found this approach especially useful with people who have been abused, have abused others, or who have experienced major trauma in their lives. It is a style of therapy that can be adapted to meet the needs of people with mild, moderate and severe disabilities. We believe in the importance of attuning to how best the client communicates – sometimes that is primarily through words, sometimes not. With clients with more severe disabilities we may use dolls, drawings, symbols or other tools of communication. With people with such significant disabilities the pace of therapy may need to be much slower than normal.

With people who have learning disabilities and mental health problems we are especially careful about the approach we use. Sometimes a mixture of psychodynamic therapy and some cognitive work helps people who are not too dogmatic about what people need at particular times. Needs may change through the course of therapy, and we constantly assess who much therapy is helping.

Other therapies include cognitive analytic therapy, interpersonal psychotherapy, systemic therapy, humanistic and experimental psychotherapies, art therapy, music and drama therapy. Respond does not specialist in these in these forms of therapy. If you would like to know more about how they work, the Department of Health has fact sheets which explain these approaches in more depth (Department of Health | Mental Health)

CRITERIA FOR THERAPY

Respond provides psychotherapy to people with borderline, mild, moderate or severe learning disabilities who have experienced:

Physical, sexual or emotional abuse
Loss
Behavioural and emotional problems
Difficulties in relationships
Depression
Eating disorders

Respond also provides specialised assessment and treatment for people with learning disabilities who have abused others, or at risk of doing so. The aim of this work is to address the root causes of offending behaviour, which are often located in early experiences. Although psychotherapy on its own cannot make people less dangerous, if it is part of an integrated support package it can be a key tool in managing and reducing risk.
We usually have at least one psychotherapy group running, for clients who may benefit more from sharing their thoughts and feelings with other people with learning disabilities. These groups have included: women’s groups, men’s groups and young people’s groups. In some cases a combination of individual and group psychotherapy is recommended.

ASSESSMENT FOR THERAPY

Assessment is a crucial part of our work. After speaking to the referrer and deciding whether to take on the case, a psychotherapy assessment is set up. First of all we meet with professionals and carers who can tell us more about the reasons they want to refer someone for therapy with us. We clarify the level of the learning disability, whether the client has mental health problems and the ways in which he or she communicates feelings. We gather information that can help us understand their history and their current problems. This meeting is also a chance for us to answer any questions the support network has about how we work. A therapist then meets with the person with learning disabilities who wants therapy. This is usually a one off session, but can be more if the client has particular problems in verbal communication. In these sessions the therapist will be listening carefully to what the client says about themselves, what they feel about therapy and how ready they are to think about difficult parts of their lives. A crucial part of this session is an exploration of whether the client actually wants to come. We do not work with clients who do not consent to attend.

FUNDING

Funding is left to the referrer to arrange (see attached price list). There is a separate charge for the assessment. You do not need to have a secured funding before we do the assessment, although it is highly advisable to be exploring this. We discuss with you how often you prefer to be invoiced – whether it is in batches of 12 or 44 sessions. We have to charge for all sessions. (see charging policy attached)

REPORTS

Written reports are provided to referrers every 12, 24 or 48 sessions. These are written with the consent of the client and contain information on the client’s attendance and their general engagement in the work. Because of clients confidentiality we will not provide detailed information on the content of sessions, unless this information relates to abuse or abusing. Clients are informed (and, if necessary, regularly reminded) that the session remains private unless they disclose they are being abused or are at risk of abusing someone else. When such disclosures are made, our policy is to inform the most appropriate professional in the support network.

SUPPORT FOR WORKERS

The therapist seeing the client tends not to liase directly with the support network. Instead, another Respond clinician deals with all communication, and helps arrange review meetings as necessary. Although we are protective of the content of the therapy session, we encourage dialogue between ourselves and a client’s carers. We recognise that therapy can sometimes make people feel or act worse before they feel or act better, and wish to help teams and other carers deal with difficulties this provides. We have a team of skilled therapists able to offer on going supervision for teams, not just about a particular client, but also about working generally with issues of disability and abuse.

ENDING THERAPY AT RESPOND

Because every one has different needs, it is difficult to be precise about how long therapy will last for each client. Our experience is that people need between at least one and three years. Some clients need longer, depending on such things as severity of the trauma they have experienced, their verbal/receptive communication skills and the pattern of their early attachments. In addition to formal three monthly review, Respond undertakes on going assessments of whether therapy should continue. These take place in clinical supervision with an external consultant. When it is judged that a client should end their work with us, we talk with the support network about the reasons for this, and discuss ways of managing a planned ending. Because of the intensive nature of therapy and the strong attachment that can develop between therapist and client, we are mindful of the need for support for client and team once the therapy has ended. We recommend regular meetings at Respond through the ending process, with follow up sessions afterwards.

If you wish to discuss whether therapy can benefit your client, please ring us on 0207 383 0700 or email us on admin@respond.org.uk

Referrals

Referrals are either made by contacting us on the number below, or downloading a refferal pack and returning it to us. If a referred client meets our criteria, they will be offered an assessment to see whether or not the therapy that we offer is the most appropriate way forward.

Respond