Many people within a rehabilitation and recovery (R&R) environment will have a range of needs and presentations, including severe and enduring mental health needs, dementia, brain injuries, autism and a learning disability. People may also be moving into the setting from another service, and are likely to be referred from the NHS.

At Priory Hospital Middleton St George, the R&R team's aim is to help people move back into the community (or their most suitable environment) and achieve the goals that they have their heart set on, such as finding a job or having the right home.

Recovery is an ongoing, lifelong process

Dr Steve Ramplin, Consultant Forensic Psychiatrist at a male high-dependency ward at Priory Hospital Middleton St George says that "recovery is an ongoing, lifelong process". Working as part of a well-resourced team, including a full-time psychologist, occupational therapist and a highly experienced nursing team, many of their patients are able to "make that full journey" to recovery.

Alongside taking part in one-to-one therapy sessions, these patients are encouraged to engage in other activities that challenge them, to aid recovery. These include:

• Preparing meals for other residents
• Volunteering at a local dog shelter
• Taking part in meetings with staff to offer feedback on their care

Dr Ramplin says: "It shows we take their concerns seriously and we're listening to them. And it breaks down some of the barriers that can exist between staff and patients.".

R&R services at Priory Hospital Middleton St George

The separate male and female R&R settings at Priory Hospital Middleton St George provide a robust programme of care for people with complex needs, empowering them to manage their own risk and recovery.

The team utilise a model of care that recognises the seven principles of recovery:

• Hope
• A secure base
• A sense of self
• Supportive relationships
• Empowerment and inclusion
• Coping strategies
• Purpose

The multidisciplinary team (MDT) work to prepare the patients to progress along the rehabilitation pathway. This includes engaging families and carers to support the development of relationships, organising increased access into the community and helping patients to become more involved in meaningful and enjoyable daily living activities.

The treatments that people in the R&R setting have access to at Priory Hospital Middleton St George include:

• Dialectical behaviour therapy (DBT)
• Cognitive behavioural therapy (CBT)
• Trauma-based therapy
• Substance misuse work
• Relapse prevention
• Social and life skills training
• Reactive anger - CALM
• Problem solving skills training (PSST)
• Emotional management
• Mindfulness
• Psychodynamic approaches

This treatment is underpinned by the following:

• Holistic biopsychosocial treatment
• Evidence-based pharmacotherapy/medical management and medication
• Concordance therapy
• Comprehensive physical health assessment and monitoring, including healthy lifestyle interventions for diet management, exercising and smoking cessation
• Individualised positive behaviour support (PBS) plans
• Personalised daily activity schedule (structured day)
• Skills acquisition and enhancement, vocational skills training and education opportunities
• Art and music sessions

By working closely with people to build new and existing skills, and helping them to understand and build on their strengths, the team provides their patients with the opportunity to grow in confidence and self-belief so that they can work towards achieving their goal of recovery.