Wandsworth Complex Needs Team
Who we are
We offer assessment and treatment mainly for patients with a diagnosis of personality disorder or other complex long-term emotional and relationship difficulties. The main treatment model is Mentalisation-Based treatment (MBT) in an intensive outpatient therapy programme. Other treatments available are psychodynamic psychotherapy (individual or group) and Cognitive Analytical Therapy (CAT). We have a consultation service for professionals.
Who is the service for
This service is for patients with complex long term emotional and relationship difficulties which are not helped sufficiently by medication alone or previous psychological interventions tried in primary care, IAPT or the CMHT . Most of our patients have a diagnosis of personality disorder but this is not essential. We also offer a monthly support group for friends/family/carers of people who suffer with personality disorder or similar conditions.
Where to find us
Building 1 Entrance 2
61 Glenburnie Road
Telephone: 0203 513 5000
Our opening hours
Monday - Friday 9:00am-5:00pm (although at times we may be able to provide therapy sessions outside these hours)
Who you might see / our staff
Our team is made up of therapists from many core professions – nurses, occupational therapists, psychologists, psychotherapists and psychiatrists, who are all also trained psychotherapists in MBT and/or other therapies. We are also a training centre, with psychologists and psychiatrists undertaking specialist trainings and medical and nursing students sometimes on placement with us. The main contacts for enquiries are:
Team Manager: Lisa Stubbs
Deputy Team Manager Jill Gill
Consultant Psychiatrist and Clinical Lead: Dr Jonathan Garabette
Consultant Psychiatrist: Dr Jale Cilasun
What you can expect
Everyone who uses our services first gets an assessment of their mental health needs and a plan of the care and support they will receive. They will also will also have one named person who co-ordinates their care and support. This person will be called either a named professional or, if you are in our full MBT treatment programme, a “care co-ordinator”. This person should be your main point of contact with our team. Entry to the team always starts with assessment and then may progress down a number of possible treatment pathways. A brief overview is provided below.
After receiving a referral we will send you a waiting list letter and then, when you reach towards the top of the list, a set of questionnaires for you to complete and return. After receiving these we will offer you an assessment/consultation appointment with one of our staff members. The assessment/consultation process aims to try and begin to understand your difficulties with you from a new perspective and many of our patients find this helpful in itself. Most assessment consultations take 2-3 appointments, and will usually be with the same assessor. At the final assessment consultation we will discuss our recommendations and a plan with you, whether this involves treatment in WCNS or not.
MENTALISATION BASED TREATMENT PROGRAMME:
Mentalisation Based Treatment (MBT) introductory group
MBT-I Skills group: This 12-14 week “psychoeducation” introductory group is the first step of the MBT programme, after the assessment consultations. It provides an introduction to the basic principles and concepts of mentalisation, attachment relationships and personality disorder. “Psychoeducation” involves teaching people about their mental health and difficulties and for many people is a valuable form of therapy in itself. We find that some people benefit from the MBT- group to the point they no longer feel they need further therapy. After the MBT-I group many patients will go on the waiting list for a place in the full MBT intensive outpatient programme. Others might repeat the MBT-I group or go on to other therapies or teams or be discharged from services. Patients in the MBT-I group are not yet care coordinated by WCNS and may still be under the CMHT or other teams.
Mentalisation Based Treatment (MBT) Intensive Outpatient Programme
This involves two sessions per week - one individual therapy session and one group therapy session – for 18 months. The individual therapist takes on the “care coordination” of your care and so you will be discharged from the CMHT if you had been seeing them previously and we will become the central point of contact for your mental health needs. In the initial meetings we will review your care plan, crisis plan and therapeutic aims and recovery goals and over the first couple of months produce a MBT-focussed “formulation” with you to help understand your difficulties from an MBT-perspective and help guide our treatment. There will be reviews with other members of the team (group therapists and psychiatrists) as required and at regular intervals throughout the 18month treatment programme. We sometimes find that some patients find speaking about their difficulties quite challenging and so for some patients we may recommend that they try art therapy, which allows for a different, non-verbal, way to process and understand emotional difficulties. This might be either in addition or instead of the group therapy component.
PSYCHODYNAMIC PSYCHOTHERAPY and COGNITIVE ANALYTIC THERAPY
We have a small resource for individual and group psychodynamic psychotherapies and cognitive analytic therapy. These are mostly once weekly, for 6months (cognitive analytic therapy), 1year (individual psychodynamic psychotherapy) or 2 years (for group psychotherapy).
We do not “care coordinate” patients in these therapies, so our contact is limited to the therapy sessions alone and any additional needs (crisis contacts, medication reviews etc) will need to be met by other services.
Sometimes we are asked to see patients who require specialist psychotherapies not provided locally, such as “Tier 4” (residential) treatment for personality disorders or other highly specialist services. If this is the case for you, then your current mental health service might refer you to our service for a “consultation” for our team to provide a specialist opinion about your treatment needs before deciding on whether to proceed with a referral to a specialist unit outside the Trust.
This is a tertiary service mainly accepting referrals from CMHTs and Wandsworth psychological therapies and wellbeing service (IAPT). We do not accept self-referrals so if you feel you would benefit from our service please contact your GP or current mental health team who can discuss this with you and arrange a referral if required. Any referrals from GP surgeries go through the Wandsworth Single Point of Access team and then Community Mental Health Team who can then refer to our service if appropriate.