The Therapeutic Community model of care
The Therapeutic Community is the core of Ashburn Clinic providing a unique service. It is an inpatient group-based programme for people aged 17 years or older with conditions such as personality disorders, anxiety and mood disorders, trauma-related conditions, eating disorders, addictions and co-existing problems. Health professionals with mental health and addiction problems are also treated in the Therapeutic Community.
Aims of the Ashburn Clinic Therapeutic Community
To enable patients to learn more about their problems and difficulties, thereby increasing their ability to affect change..
To encourage personal responsibility for the patient’s own behaviour and situation.
To assist patients to live successfully in the outside world without resorting to unhelpful and unhealthy behaviour patterns, particularly when faced with stressful or difficult situations.
The main therapeutic programme utilises a structured day, with an emphasis on group meetings of various kinds. Within the Ashburn Clinic community, patients enact their familiar ways of relating to other people, which is then explored through processes such as group work. Through being able to understand and communicate to others the reasons for the development of their own difficulties, patients will be better able to cope with the necessary effort and pain which characterises major personal change. The Ashburn Clinic community concentrates on the meaning of each person’s feelings, actions and relationships, so changes in understanding and behaviour can be made. Staff’s own participation in the community will ensure that as far as possible the community is an environment which enables open, honest and effective communication. Effort is made in the assessment process to understand a person’s underlying developmental deficits and to formulate these deficits psychodynamically. This understanding pervades all aspects of the treatment programme including:
Small psychodynamic therapy groups
Patients may be allocated into one of our psychodynamic therapy groups. These are groups facilitated by two people - usually a psychotherapist and a senior nurse. These groups will have approximately 8-10 patients attending and meet twice per week, forming a strong cohort of people who engage in treatment together.
Large groups and community meetings
Community meetings are twice-weekly gatherings of the whole patient group and clinical staff. This routinely includes doctors, nurses and allied health professionals together with patients. The issues that are explored include the relational dynamics between community members and how this might be reflective of themes that are occurring across the community. Once a week there is a Forum meeting for all patients and staff (including non-clinical staff) where more practical issues that affect the day-to-day running of the community are discussed.
When patients arrive at Ashburn they are assessed as to their suitability for psychodynamic psychotherapy. Therapists can provide either supportive psychotherapy or more in-depth psychodynamically-orientated psychotherapy. The majority of patients are allocated a therapist but a small minority are considered too unwell to utilise individual psychotherapy - for example, those with severe depression or psychosis.
Living and learning activities
These activities, eg. gardening, cleaning, cooking, are undertaken in the community. People are expected to participate and be able to help even in minor ways. Absences from activities are noted as people are all valued members of the community. These are opportunities for new and learning experiences, as well as relational experiences.
Creative and recreational activities
It is often a very important part of a person’s treatment to learn how to use “down time”. Art, music and sport is encouraged in the day-to-day programme with specific groups related to these activities. Weekend and evening activities offer opportunities to obtain maximum therapeutic benefit for patients.
Ashburn has given me my life back. The patients and staff have stuck by me as I have been trying to understand myself and my behaviour. It has taken a long time but it has worked and I leave Ashburn ready to go on with my life."