Psychology support for adults with complex needs

At Richardson Care, we offer psychology support for adults with complex needs, who also have acquired brain injury or learning disabilities, to support their well-being and mental health. Dr Pedro Areias Grilo, Consultant Clinical Neuropsychologist, heads up the psychology team and is supported by three Assistant Psychologists, including Julita Frackowska. The Assistant Psychologists are assigned to specific service users according to their needs and the homes in which they live. The psychology team offers one-to-one psychology support for all service users. For example: support with weekly planning, support with diet, managing psychosis and mood. Service users are encouraged to speak with members of the psychology team at any time and can visit the psychology office whenever they wish.

Person-centred care

The ethos of the psychology team is the one that runs through the organisation as a whole: the service user is at the centre of everything we do. We are committed to providing individualised care to effectively support the nuanced needs of each service user. We take a person-centred approach and offer interventions to service users based on cognitive behavioural models, dialectical behaviour skills and operant conditioning. All of the interventions offered are evidence-based and follow NICE guidelines.

Psychological reviews

All service users receive an initial psychological review, which includes neuropsychological assessments, a review of clinical presentation, assessment of stability of mood and suggestions for future interventions. This review is then repeated on a regular basis to assess the effectiveness of the therapies and interventions delivered. In addition, we have an ‘open door’ policy at Richardson Care, so all members of the psychology team, and the Assistant Psychologists in particular, can develop close working relationships with the service users. This means that their well-being can be monitored closely on an informal basis and we have found that this helps to maintain their mental health, so any problems can be addressed early, preventing the need for crisis care.

Drug and Alcohol Misuse Work

Many individuals with a brain injury or learning disability may also suffer with problems relating to past drug and alcohol misuse.  We are dedicated to providing a non-judgemental and supportive environment to aid individuals in all aspects of their recovery.  The drug and alcohol misuse programme follows a person-centred CBT model that can be adapted for both group and individual settings.

Cognitive Stimulation Therapy (CST)

CST is a therapy that aims to promote and reinforce growth in areas such as memory, concentration, attention, communication and social interaction.  CST is conducted in a group setting and follows a modular cycle of various activities and exercises.

Positive Behaviour Support

Positive Behaviour Support (PBS) is a key part of the psychological support that we provide and an emphasis on positivity is one of our main philosophies. PBS Plans are person-centred and designed with input from the service user to promote positive behaviour. They are supported to set their own goals and to achieve them.

In addition, Pedro and the team are working on an innovative Positive Behaviour Tool to more effectively monitor and encourage positive behaviour. This runs alongside the traditional techniques of reducing negative behaviour.

Relaxation Group

A weekly relaxation group is offered at all of the homes. This group session aims to teach relaxation methods and includes progressive muscle relaxation exercises as well as guided imagery.

Multi-Disciplinary Team

The psychology team works closely with the other members of the multi-disciplinary team. (This comprises a consultant neuropsychiatrist, homes managers, service manager, physiotherapist, speech & language therapist and occupational therapist.) Pedro and Consultant Neuropsychiatrist, Dr Seth Mensah, work closely together to balance the use of drug therapies and psychosocial therapies. Where possible, we aim to focus on psychosocial approaches and gradually reduce the reliance on drug therapy to achieve better outcomes for service users over the longer term.