Structured clinical management is one of the interventions we offer as part of our complex emotional and relational needs (CERN) pathway. This was established in 2022, as part of wider plans to transform our community mental health teams.
People with complex emotional and relational needs are sometimes referred to as having a personality disorder, but feedback from the people we support is that this term can be negative and unhelpful.
We have a structured clinical management team in each borough, which includes a consultant clinical psychologist and clinical lead, structured clinical management practitioners, and structured clinical management link workers. Some teams also have peer support workers from community groups such as MIND.
We work very closely with a range of services in our local communities, to provide our service users with a joined-up approach to their care.
What is structured clinical management?
Structured clinical management (SCM) is an evidenced based intervention for people who have longstanding difficulties in the below four areas. These difficulties have a significant impact upon people’s lives. Structured clinical management may be helpful for you if you have difficulties with the following:
- Making and keeping healthy relationships
- Managing emotions and mood
- Impulsivity (managing urges to act quickly)
- Self-harm and suicidal thoughts
What can I expect?
Structured clinical management allows a structured process of assessment, socialisation, treatment, and transition to ending.
Initially you'll be invited to complete an assessment with the structured clinical management team. This takes between six and ten weeks to complete.
You'll have weekly one-to-one sessions with your structured clinical management worker to gain an understanding of your difficulties and how they have developed.
You'll be asked to complete some questionnaires about your difficulties and develop an individualised safety plan. You’ll also have the opportunity to discuss if structured clinical management, or another approach, may be helpful to you.
Some people may feel ready to engage with the structured clinical management programme, or an alternative option, after completing their assessment.
However, some people may benefit from up to 12 weeks of socialisation. This time will be used to problem solve any difficulties about coming to group sessions or committing to change.
Your structured clinical management worker will work with you to set short- and long-term goals, agree a treatment contract about what to expect and what is expected of you, and develop a more in-depth safety plan to help you during difficult times.
The treatment involves a combination of weekly group work and individual sessions with your structured clinical management worker. It typically takes about 12 months to complete but can vary.
We will help you to develop skills to address your difficulties and meet your goals by focussing on four key areas:
- Problem solving
- Understanding and managing emotions and mood
- Understanding and managing behaviours that put you at risk
- Understanding and managing relationships.
The treatment phase of structured clinical management requires attendance at both group and individual sessions.
The group work is central to the structured clinical management programme and aims to give you the best opportunities and outcomes from the programme. The group sessions are held on a weekly basis and last for 1 hour and 30 minutes.
Transition to ending
Once you have completed the treatment phase, you’ll have a period of one-to-one sessions with your structured clinical management worker.
You’ll use these sessions to jointly review the skills you have developed, plan how you can maintain these in the future and explore the resources and support you’ll need moving forward (e.g. linking it with local community groups and agencies).
If you think you may benefit from structured clinical management, please speak to your care co-ordinator.