Day Services Programmes

An 8 week programme focussing on how to manage thoughts and emotions more effectively, with an emphasis on mindfulness skills and connecting with values. Each week group members learn new skills to help them deal with difficulties experienced in daily life.

Acceptance & Commitment Therapy (ACT) is a form of therapy that teaches mindfulness skills. There is also a large emphasis on connecting with values; to that which matters the most to us. This helps to align our actions and bring us towards where we really want to be.

Mindfulness skills enable us to learn to be in the moment, connect more to who matters and make the most of each and every day. Mindfulness skills help us to unhook from unhelpful thoughts and to struggle less with uncomfortable emotions. The programme may be helpful for those who have experienced depression, anxiety, bipolar, addictions or psychosis.
One of the key aims of ACT is to help increase our levels of psychological flexibility. When we have greater psychological flexibility it does not mean that we will never feel down or stressed again. What it does mean is that when unwanted or difficult situations arise in our life we are able to respond to them by adapting and applying the skills that we have learned.
The programme aims to help you get “unstuck”. We all get stuck at certain points in our life. ACT aims to teach us the skills so that we can learn to manage these thoughts and emotions more effectively and take effective action in our lives.
The programme is organised over a period of 8, 3.5 hour, weekly sessions. We also offer aftercare which is one half day a month following completion of the 8 week programme.

Course Content:

• Introduction, and looking at our lives in terms of workability
• Connection, learning to live more in the moment which has been shown to help prevent depression relapse
• Thought defusion-learning skills to help us to ‘unhook’ from unhelpful thoughts
• Expansion; learning skills to help us struggle less with uncomfortable and unwanted emotions
• Values; learning to connect with what is most important to us
• Observing Self; learning to connect more with the observing self, that part of ourselves that notices without judgement. The part of ourselves that notices without judgement. The part of us that recognises all the different aspects of ourselves.
• Committed Action; Do today what it takes. Learning strategies to break our long term goals down into smaller steps and also learning skills to help us get back on track.
• Review of ACT and how to apply it in your life on any day basis.

This is a day patient programme based at St Edmundsbury Hospital, Lucan.

The Access to Recovery Programme at SPMHS is a distinct and organised mental health treatment programme delivered on two levels. It is designed to provide an individualised and coordinated treatment programme that is open and accessible; enabling a seamless transition period from admission to day care without the barriers of waiting times for closed programmes.

This programme is a two-tiered structured programme that provides a stable therapeutic base for continuous assessment, high levels of support and therapeutic interventions.

It is provided as an alternative, or in addition to inpatient hospitalisation or in advance of a diagnosis specific programme. The programme focuses on
addressing each individual’s needs. Attendance is between 1 and 4 half days for a period up to four and a maximum of six weeks.

A 12 week programme is designed to meet the needs of people who have recently been discharged and in early recovery of drug or alcohol abuse, or for those who are struggling with recovery or relapse.

The Step Down Programme is a 3 month programme designed to meet the needs of those who have been discharged from the inpatient programme and are in early recovery from alcohol and/or substance abuse. It is known that recovery from alcohol and/or drug addiction is a staged and continuous process.

Service users attend this support programme, facilitated by an addiction counsellor one half a day per week for 12 weeks. The Step Down Programme also gives the opportunity to those who have experienced relapse or are struggling with recovery from alcohol and/or drug abuse to re-engage in recovery with the help of professionals.

This is a day patient programme.

This programme, based on Cognitive Behavioural Therapy and Compassion Mindfulness Based approaches, focuses on addressing the physical, psychological and behavioural aspects of the anxiety disorder using group psychotherapy.

The Anxiety Disorders Programme was specially founded to provide for the needs of people with a Primary Anxiety Disorder. This is a core feature of the Anxiety Disorders Service and is a unique diagnostic treatment programme for this client group. The programme caters for the needs of a wide range of disorders - Panic Disorder, Agoraphobia and Specific Phobic Disorders, Social Anxiety Disorder, Obsessive-Compulsive Disorder, Generalised Anxiety Disorder. The aims of the programme include increasing knowledge and understanding through psycho-education, group and individualised psychotherapy.

Additionally it provides individuals the opportunity to learn therapeutic skills and strategies to help overcome their difficulties. It focuses on addressing the physical, psychological and behavioural aspects of the anxiety disorder using group psychotherapy. The therapeutic framework of the programme is based on Cognitive Behavioural Therapy and Compassionate Mindfulness Based Approaches. The Anxiety Disorders Service is a comprehensive, multi-disciplinary, assessment, treatment and aftercare service for sufferers from primary Anxiety Disorders. It aims to deliver the best available treatments for anxiety in an accessible and flexible way as well as providing follow up care and support for those that need it.

This programme is available for inpatients and day patients.

The Bipolar Education Programme offers educational and supportive interventions in the ‘Post Acute’ phase of a person’s Bipolar illness, so that recovery and the development of self-management skills are supported. Support and Information sessions are also offered to families in this programme.

The Bipolar Education Programme offers educational and supportive interventions in the ‘Post Acute’ phase of a person’s Bipolar illness, so that recovery and the development of self-management skills are supported. Support and Information sessions are also offered to families in this programme.

This involves prolonged engagement with this specialist service. The initial Foundation week focuses on introducing core concepts and information which will help each person understand their Bipolar illness experience more fully, followed by a one day programme for 12 weeks. Similar content themes are addressed over the twelve weeks but in greater depth with a focus on applying new learning to one’s personal circumstances. The development of self-management skills is a key objective of the programme and encourages the active engagement of supporters along the way. Self Management simply means becoming an expert on your illness and taking charge of staying well. Various strategies are explored that have been proven to help a person to maintain their mood stability and reduce the risks of recurrence. Having a strong support system is vital to sustained recovery; therefore to encourage those in recovery to seek out the help of others and develop a support network around them, two information and support sessions are offered to families and supporters over the course of the 12 week day programme.

This programme is available for inpatients and day patients.

The Compassion Focused Therapy programme was developed for service users whose mental health difficulties are maintained by high levels of shame and self-criticism, and who are motivated to work on these issues with others in a group. The group aims to help participants learn new ways of understanding their difficulties and develop a different way of relating to themselves.

Through becoming more self-compassionate, group members become better able to engage with their distress and to work toward alleviating that distress.

During the programme, members learn and practice compassionate imagery exercises, work with their self-critical ways of thinking, and identify compassionate behaviours to move them toward desired changes. The group typically meets one day per week over a period of five to six months.

Referrals are accepted from psychologists working with MDT’s at St Patrick’s Mental Health Services (SPMHS).
Currently places are only available to service users under the care of a consultant psychiatrist at SPMHS.

This is a 25 session closed group which offers a comprehensive psychological therapy for individuals who can manage recovery from their eating disorder in the community.

The individuals who will benefit from this intervention tend to share many common problems including being worried about their size, shape, and weight. They are also likely to use food, dieting, activity, vomiting or weight loss drugs to manage difficult experiences, relationships, or painful thoughts, feelings and memories. The group incorporates psycho-education for both patients and their family members; skill building and therapeutic elements. It aims to target both biological starvation and the underlying psychological processes which underpin and maintain an eating disorder.

This is a day patient programme.

This is an eight-week comprehensive Family Training Programme designed to empower any family member/Concerned Significant Other ‘Living with Addiction’.

Family members can, and do, make important contributions in areas of addiction treatment, and can play a powerful role in reducing their loved one’s harmful drinking or using, engage them into treatment, and improve their own emotional, physical and relationship functioning.

CRAFT teaches the skills to train and prepare any family member/CSO to influence their loved one, whether in treatment or resisting treatment.

CRAFT’s 3 Major Goals

• Reduce loved one’s harmful drinking/using
• Engage loved ones into treatment
• Improve the functioning of the Concerned Significant Other

Purpose

• Empower CSO to influence change
• Train CSO in behaviour change skills
• Improve CSO’s quality of life
• Prepare CSO for treatment engagement

Rationale for Working with CSO’s

• Substance abusers often report that family pressure prompted treatment seeking
• CSO’s can influence substance abusers’ behaviour due to extensive contact
• CSO’s also need help (victims of violence, financial problems, and marital conflict etc.)

CRAFT Programme Description for the CSO

Problem-focused
• Skills-based
• Active during sessions (Role Plays)
• Active between sessions (Assignments)

Duration: 8 Sessions over 8 weeks for 2 hours on a Thursday evening from 6.00pm - 8.00pm.

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In line with international best practice guidelines for depression, the Depression Recovery Service offers a group based stepped care approach using an ABC model (Activating Depression, Building Recovery, Compassionate Resilience.
The Service is run by a team of Mental Health Care Practitioners that includes Consultant Psychiatrist, Clinical Nurse Specialist and Psychotherapists with expertise in Cognitive Psychotherapy, Compassion focused therapy and Systemic Psychotherapy.
In line with international best practice guidelines for depression the Depression Recovery Service offers a group based stepped care approach using an ABC model.

There are currently three programmes offered within the service.

Activating Recovery – Level A

A three week programme that is offered to inpatients and day-patients who attend the service. Participants attend two half days each week. The programme provides education about depression and introduces various recovery principles and treatment approaches. All participants are encouraged to develop skills through behavioural activation, goal-setting peer support and engagement in group based personal reflection.

Building Recovery - Level B

A four week closed psychotherapy programme. Participants attend a full- day workshop each week through the Day Services. Workshops have been designed around models and approaches of Cognitive Psychotherapy and Compassion Focused Therapy. It also incorporates reflection and mindfulness.

The workshop offers individuals an opportunity to apply the various models to their own experience. This facilitates the development of a personal understanding of how specific situations may trigger negative thinking styles; distressing emotions; physical states and behavioural reactions that maintain depression. Participants are also introduced to the concept of the compassionate mind and emotional regulation systems.

Compassionate Resilience - Level C

Compassionate Resilience is an eight week psychotherapy programme. Participants attend a full-day workshop each week through Day Services. The programme builds on concepts introduced in level B and is therefore offered to people who have completed Building Recovery and wish to develop a deeper psychotherapeutic understanding of the impact of depression in their life. Underlying factors that may have increased vulnerability to Depression are also explored and each individual is encouraged to develop a personal conceptualisation.

“Compassion focused therapy targets the activation of the soothing system so that it can be more readily accessed and used to help regulate threat based emotions of anger, fear, and disgust and shame” (Paul Gilbert, 2012)

Emotions make thoughts more meaningful and credible. We identify more with thoughts when we can link them to an emotional experience. If we have limited memories of feeling soothed or loved in childhood we may struggle to link compassionate and soothing thoughts to emotions that help to validate the thought and activate feelings of soothing. This programme hopes to facilitate the development of compassionate Resilience.

This programme is available for inpatients and day patients.

The programme consists of a team of experienced and qualified professionals who are dedicated in working together to treat and support individuals and carers towards recovery from an eating disorder.

The programme provides a comprehensive assessment and tailored treatment according to the needs of the individual.
The services are seamless and service-users can step-up or step-down from one aspect of the programme to another depending on their needs and stage of recovery. Treatment is delivered by an innovative multi-disciplinary team. The team works together with the participant and, if appropriate, families, to enhance physical and emotional wellbeing along their path of recovery.

The St Patrick’s Day Care Eating Disorders Service provides care for those over the age of 18 with:

• Anorexia Nervosa
• Bulimia Nervosa
• Eating Disorders, not otherwise specified (EDNOS) including binge eating disorder
• Obesity secondary to underlying binge eating disorders

Admission to the day care service is either directly as a step down from inpatient care or step-up from out-patient care. The day service is an alternative to hospitilisation for those who need extra support but can manage with a less intensive treatment.

The day care service runs from Monday to Thursday 9.30-4.30 and usually lasts around eight weeks depending on your individual needs and progress. Initially it is recommended to attend for four days per week and this is reduced over the course of the eight weeks. The majority of treatment provided is in group format but individual therapy is also available.

This programme is available for inpatients and day patients.

Group Schema Therapy (GST) is a closed long-term group designed to treat individuals with a diagnosis of Borderline Personality Disorder (BPD). The group provides an evidenced based treatment to service users.

GST helps service users to change their entrenched, self-defeating life patterns, or schemas, using cognitive, behavioural, and emotion-focused techniques. The treatment focuses on the relationship with the therapist, daily life outside of therapy, and the traumatic childhood experiences that are common in this disorder. The group is broken down into 3 stages over an 18 month period: Stage one (months 1-3) are for bonding and emotional regulation; stage two (months 4-11) is the schema mode change period and; stage three (months 12-18) is the autonomy stage.

This programme is for people who struggle with low self-esteem. It is directed towards people who are interested and motivated to find out how Cognitive Behavioural Therapy (CBT) can help them understand and improve their self-esteem through implementation of the key concepts and techniques of CBT.

Low self-esteem can be a very debilitating phenomenon often leading to, or exacerbating, anxiety and/or depression. CBT can help the individual address their low self-esteem and develop a more positive attitude towards oneself, whereby the individual acts in an accepting, respectful and trusting manner towards oneself.

Admission to this programme is through a referral from your consultant or multidisciplinary team. Following the referral you will be contacted by a member of the Day Service Department and attend for an initial assessment.
Following the initial assessment you will be attending the introduction to CBT programme for 4 sessions. This, in part, acts as further assessment for the Healthy Self-esteem Programme. After completion of the Introduction to CBT course and in consultation with the CBT group facilitator, a collaborative decision is made in relation to commencing the ‘Building Healthy Self-esteem Programme’.

This is a day patient programme based at St Edmundsbury Hospital, Lucan.

The Living Through Distress Programme is aimed at service users who find their emotions difficult to regulate. Participants often report urges to self-harm or carry out behaviours that are self-damaging.

A set of 8 skills (based on Dialectical Behaviour Therapy) are taught and practiced so that participants develop new ways of dealing with intense or distressing emotions. Sessions are held three afternoons a week over a six week period. There follows one group a week for four weeks and then one group a month for four months. Referrals are made through the multi-disciplinary teams.
This programme is available for inpatients and day patients.

The Living Through Psychosis Group aims to provide skills necessary to cope with the distress that living with psychosis can bring.

Psychosis is a mental health difficulty that impacts on a person’s way of thinking, feeling and behaving and it can also impact on how the person relates to loved ones.

The skills particularly target staying well after psychosis and attempts to reduce the likelihood of relapse. The group provides a good follow up for those who have already completed the Psychosis Education Programme

The Program aim to address beliefs about psychosis, to reduce the likelihood of relapse, to reduce distress and preoccupation associated with symptoms and to increase hope and everyday functioning.

Eight skills are delivered in the programme, which currently runs twice a week, for four weeks at a time. A bi-monthly aftercare group is also provided for those who complete the programme.
This programme is available for inpatients and day patients.

This programme is aimed at individuals who suffer with depression and as a result, reduced interaction or motivation to participate in life activities. The course aims to help individuals feel more empowered in their mood management.

Often in a depressive episode, individuals struggle to feel motivated to engage in even minimum activity. This programme is designed to help individuals identify the link between behaviour and mood, encouraging increases in activity to help elevate mood.

The course aims to help the service user;

• foster attitudes, skills and behaviours conducive to sustaining recovery and health.
• explore and challenge maintaining factors of depression.
• encourage participants to discover their personal formulation and to generate therapeutic change

Programme Breakdown

Week 1:

• Introduction and understanding of depression
• Mindfulness

Week 2:

• Understanding the role of behavioural activation in managing depression, and barriers to change introducing activity records
• Mindfulness

Week 3, 4:

• Identifying unhelpful and helpful behaviours and goal setting for behavioural change introducing activity scheduling
• Mindfulness

Week 5, 6, 7:

• Getting out of the trap and back on track
• Mindfulness.

Week 8: Review and consolidation.

This programme runs for a half day a week for 8 weeks. There will be a maximum of 14 participants.

This is a day patient programme based at St Edmundsbury Hospital, Lucan.

The Mindfulness Based Stress Reduction (MBSR) course focuses on empowering people to open up to their experiences, ‘be present’ and cultivate the kinder, compassionate self. This approach aims to teach people a set of skills to help manage daily and on-going difficulties that present for them, encompassing physical and psychological problems or challenges.

Mindfulness origins are derived from the belief of ‘living in the moment’. It is the practice of purposefully paying attention moment by moment, in a non-judgemental way. The practice is sometimes referred to as “practising being”, that is, the tuning into each moment in an effort to remain awake and aware from one moment to the next. The practice includes:

• Learning how to make time for one-self.
• Learning how to slow down and nurture calmness and self-acceptance in oneself.
• Purposefully allowing the body and mind to come to rest in the moment, no matter what is “on” one’s mind or how one’s body feels

The approach combines ancient traditions with current knowledge, understanding and research.

This is a day patient programme.

Other Resources

The Pathways to Wellness Programme is a group based support and reengagement programme for individuals lacking motivation, confidence and opportunity to change and move forward towards their recovery.

The programme aims to offer opportunities to engage in activities which will encourage participation and reengagement in community/society.

Psychology Skills Group is a skills training group for out-patient young people aged 13-17 years which is centred on learning a mixture of skills from DBT (Dialectical Behaviour Therapy) for adolescents.

The structure of the group features five modules each containing four weekly sessions, running for a total of five months.

New referrals are welcome to join at the beginning of each new module every month but need to attend a screening appointment prior to this.

Once the referral form is received and insurance cover is cleared, a senior clinical psychologist will meet with the young person and their caregiver/parent to assess their suitability for the group. Feedback will then be given to the referring team on suitability for the programme. If the young person is not suitable for the group further recommendations will be made.

Programme for older adults that aims to provide skills to improve awareness of emotions and learn how to better manage them.

The group is designed for:

• Older adults;
• Experiencing depression and /or anxiety
• Have had little previous contact with psychology services
• Are willing to engage in behavioural change and practice new skills
• Are able to travel to the hospital every week

The group is not suitable for patients in Special Care, those with active psychosis, or moderate to severe cognitive impairment. Eight skills are provided over 16 weeks. Sessions run on Tuesday afternoons from 2 pm in St Patrick’s University Hospital.

This programme is available for inpatients and day patients.

The psychosis recovery programme is an intensive 3 week programme catering for both inpatient and day patients. It aims to provide education around psychosis, recovery strategies and specialist cognitive behaviour therapy (CBT) skills to help participants cope with the distressing symptoms of psychosis.

The programme groups focus on:
• Recovery Strategies
• Practical facts about psychosis
• Social support
• Staying well using medication effectively
• Cognitive Behaviour Therapy
• Building Resilience
• Occupational Therapy

The Programme is delivered by members of a multi-disciplinary team which include: a Consultant Psychiatrist, Clinical Nurse Specialist, Clinical Psychologist, Occupational Therapist, Social Worker and Pharmacist. The psychosis recovery programme is an intensive 3 week programme catering for both inpatient and day patients. It aims to provide education around psychosis, recovery strategies and specialist cognitive behaviour therapy (CBT) skills to help participants cope with the distressing symptoms of psychosis.

The Radical Openness programme is aimed at service users who mask or hold back their emotions, keep a safe distance from others and go to some lengths to control their environment.

Participants often report that, despite their best efforts, they can end up feeling isolated and depressed.

A set of nine skills are taught so that participants develop insight in to how a tight control of emotions can create as well as solve problems and how they might develop a set of more flexible styles.

Sessions are held two afternoons a week over a nine week period. This is followed by one group a week for four weeks and then one group a month for four months. Referrals are made through the multi-disciplinary teams.

This programme is available for inpatients and day patients.

The Rapid Access Day Programme is a trans-diagnostic (generic) day programme which aims to provide assessment and treatment as an alternative to inpatient hospitalisation. This open programme is designed for all service users who attend St. Patrick’s Mental Health Services through day care and who are considered to require a high level of mental health support but not requiring inpatient admission. Each service user will have their timetable tailored to their needs attendance is between 1 and 5 days for a period of up to four weeks.

The Recovery Programme is directed at mental health service users who
are discharged or who may want to avoid coming into hospital. The main emphasis of the Recovery Programme is the creation of your own WRAP® (Wellness Recovery Action Plan). It aims to educate each person, allowing them to self monitor their mental health using their WRAP® Plan and to address factors that may impede or support their Recovery.

While WRAP® is delivered as one segment, additional group work sessions on Recovery topics which support WRAP® are also included, e.g: Motivation to change, Self and Relationships, Self esteem, Building Social Supports and Enhancing general health.

The WRAP® segment of the programme is facilitated by accredited advanced level WRAP® facilitators who received their training from the Copeland
Centre.

The Recovery Programme is delivered as follows:

The Recovery Day Programme
The Recovery day Programme is a 12 day programme consisting of 2 days per week over a six week period. The typical hours of this programme is 9.30am - 4.30pm.

The Recovery Evening Programme
The Recovery Evening Programme comprises of one evening a week for eight weeks (Thursday evening 6.00pm - 9.30pm). The Recovery Evening Programme is designed specifically for those who cannot attend the day Recovery Programme due to work or college commitments.

The Refresher Workshop
The Refresher Workshop is available to those who have completed either the Recovery Day or Evening programme. It is Recovery focused and aimed at those who are using their WRAP® Plan and would like some assistance in updating it or recapping on all aspects of WRAP®.

The aim of this programme is to enable service users acknowledge changes they may need to make in their roles and relationships during their transition to wellness in order to maintain their recovery.

When someone has gone through treatment there may be changes they need or want to introduce in their lives to help them to maintain their mental health.

Every individual is made up of various ‘parts’; a daughter, father, aunt, accountant, actor, friend etc. The roles that we have in our lives, whether they are chosen (career) or we are born into them (son/daughter) continuously evolve throughout our lives in the face of life events & as we journey through the life cycle.

The aim of this programme is;

• to facilitate service users in their journey from illness to wellness by acknowledging that they may need to introduce changes in their roles within relationships in order to prolong their wellness;
• to acknowledge that a change may have occurred, triggering an episode of illness which the service user needs to develop skills to adapt to.

This is done by;

• helping to identify the different roles that make up the whole self, and the tasks and expectations within those roles.
• Helping to identify the roles or tasks that we wish to change.
• explore skills, strategies and obstacles to implement the desired changes.
• recognize the impact that this change may have on those around us and the impact their subsequent behaviour has on us.

These changes may be temporary or permanent. They may be within working relationships or intimate relationships. They may involve introducing new roles to their lives.

Throughout the group we look at both strategies for and obstacles to introducing change. The goal is not to have all changes introduced by the end of the four weeks, but to have begun the process of change.

The Roles in Transition group runs for a half day each week for four weeks and facilitated by a Systemic Family Therapist. The minimum number of attendees is 6 and the maximum is 12. This programme is not suitable for anyone experiencing psychotic symptoms or suicidal thoughts; who does not wish to work in a group setting; or who cannot attend the four group sessions.

This is a day patient programme based at St Edmundsbury Hospital, Lucan.

This is a psychological therapy group for older adults who are experiencing difficulties with anxiety and /or depression and are interested in applying a psychological approach to their difficulties. The aim of the programme is to improve coping and mental health in general. The group is based on the premise that service users have an active role in managing their mental health.

The young adult programme (YAP) is a specialist group based intervention for those aged 18-25. The programme has been carefully designed to include discussion groups and leisure activities to aid recovery.

YAP aims to increase self-esteem, facilitate ones recovery and to learn more about how to manage one’s own mental health

This programme is available for inpatients and day patients.