Treatment, Treatment Plans and Consent
Simmons House provides many different types of treatment. These include medical, psychiatric, psychological, educational, group-work, occupational, family and individual therapies. Evidence-based practice and the experience of the team, underpin all of the clincal treatments.
Videoing of family therapy meetings and having members of the team observing family work is an important evidenced-based aspect of the treatment programme at Simmons House. This is always done with the full consent of the young person and their family/carers.
Around the time of admission, the plans for treatment will be discussed and agreed with the young person and their family/carers, as well as the referring team. We believe that working together closely with all those involved in the treatment and care of the young people is more likely to lead to positive change. We also understand, however, that some young people do not always want their family/carers involved in their care, and we will aim to respect these choices whenever possible.
A copy of the treatment plan will usually be provided to the adolescent and their family/carers. This treatment plan will be jointly signed by the case manager, and the consultant child and adolescent psychiatrist and the young person.
Simmons House always aims to work in an open, transparent and collaborative way with young people and their families/carers. The vast majority of treatments have to be consented to. Simmons House staff will inform young people both verbally and in writing of their right to agree, or refuse treatment, and the limits of this. This will be recorded in young people’s notes. In rare instances where a treatment is given against the wishes of a young person and/or parents/carers, this will be clearly explained and documented. This could be the case if a young person is at significant risk and/or detained under The Mental Health Act for example.
Treatment plans will specify:
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Name of case manager and consultant child and adolescent psychiatrist.
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Name of nurse key workers.
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Therapeutic components of treatment package.
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Clinician and young persons goals of admission.
Expected therapeutic outcomes.
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Date of the next case review, usually three months from the admission conference.
Initial Stages
Pre-admission treatment
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Some young people referred to the service may feel that they are not ready to take part in the full programme. Some parts of the treatment package (e.g. family or individual therapy) may still be offered if it is thought to be helpful.
Working together with the referring team, young people and their families/carers in the plans is an important part of the working practice of Simmons House.
Admission
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Either prior to, or soon after a young person is admitted to Simmons House, an admission conference will be held. Referrers and any other teams involved are invited to Simmons House.
Young people and their family/carers feed into this meeting and young people usually attend the majority of the meeting. Adolescents and their families/carers are given copies of the treatment plans and so further discussion can take with case managers or in family meetings.
Group Activities
Culture Club
looks at themes around self-identity, gender and cultural issues.
Art Group
is a non-directive group where young people are encouraged to express themselves through a creative medium of their choice e.g. paint, clay, paper, felt tips.
Sometimes a theme is introduced to encourage ideas. Young people are encouraged to discuss their work with an emphasis on emotional issues rather than technique or achieving a perfect piece of art work.
Group Therapy
provides a platform for free expression, with the aims to develop trust and aid the group becoming psychologically and emotionally-minded.
Leavers Group
offered to those young people in the leaving phase of their admission and those who have left Simmons House. The group allows an exploration of the leaving process, ending and a reintegration back into the young person’s community.
DBT Informed Group
A Dialectical Behaviour Therapy-informed group. The group promotes emotion regulation and social interactions through education and skill building. DBT Worksheets and infographics are used to explain important concepts, teach new coping mechanisms, and facilitate pragmatic conversation and reflection amongst the group.
Life Skills Group
To develop functional life skills to help the young people prepare for their transition back into the community from Simmons house. The group covers a range of topics such as budgeting, domestic hygiene/personal care, internet safety, problem solving, road safety etc. There are opportunities for indirect practice (i.e. games, role playing, case studies) and real-life practice (i.e. leaving the unit to practice these skills).
Lunch Cookery
a practical-based group which allows groups members to work towards a common goal. The group promotes concentration, food hygiene, safety awareness and an ability to follow instructions.
Exploring Ideas
a cognitive behavioural therapy group. Explores everyday adolescent issues and links thoughts, feelings and behaviours in order to establish coping mechanisms.
Sports Group
a group aimed at promoting fitness and a respect for physical activity as well as generating a sense of achievement, belonging and teamwork.
Friday BE
is based on mindfulness, which involves being in the present moment and paying attention, without judgment, to feelings and thoughts and their coming and going. Two forms of meditation are used to help young people notice their experiences in the moment, followed by time to reflect.
Community Meetings
The daily Community Meeting is the pivotal event in the weekday programme at Simmons House. It provides the main opportunity for the Staff Group to sit down with the young people and reflect on the past 24 hours and plan for the subsequent 24 hours in the life of the Unit.
The Community Meeting also provides a window in the middle of the day to discuss how the group is getting on and focus on what is or is not working.
After your stay
After your stay
Discharge
The service always aims for discharge to be carried out in a planned way.
Discharge plans are always written down at discharge meetings and the Care Programme Approach (CPA) is always followed. This means that all young people and their family/carers (as appropriate) receive a written summary of the treatment plans on the day a young person leaves Simmons House.
Post-discharge work
Often young people form strong attachments to the work at Simmons House. As a result, a post-discharge package can be available if clinically appropriate and agreed with referring teams. This is usually up to a maximum of 2-3 months.
The work offered can include: fortnightly nursing key-worker time and weekly attendance at an late-afternoon leavers group.
Longer-term
post-discharge work
There are very rare circumstances where a specific therapy (e.g. individual psychotherapy or family therapy) will continue to be provided from Simmons House for more than three months with the agreement of Simmons House and the referring team.