Our clinical model
Severe mental distress arises from experiences of repeated trauma and damaged and damaging attachment relationships, often exacerbated by deprivation, inequality, and stigma.
Our approach to recovery is therefore psychosocial, considering the whole person rather than just treating their diagnoses, and incorporates Therapeutic Community principles, an evidence-based approach empowering residents to develop life and social skills through activities and community management.
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In practice, this means support is person-centred and recovery pathways are co-developed with our residents, taking account of their experiences, boundaries, physical, emotional, and social needs, and aspirations.
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While every recovery pathway is tailored, each encompasses the five stages of our clinical model (outlined below), serving as a framework which residents work through at their own pace with the support of our therapeutic staff.
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Engagement
Engagement is an ongoing process of creating meaningful connections that build emotional safety. At CHT, this begins at assessment and continues throughout our residents' journeys.
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Our therapeutic practitioners work closely with each resident to create their Recovery Plan, listen to their needs, recognise their strengths, and respect their boundaries while helping them build relationships with staff and peers and develop strategies for community engagement and daily task management.
Successful engagement, whether with one person or the whole community, leads to attachment.
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Attachment
Attachment is the emotional bond we form with another person. ​We form our earliest attachments as children through relationships with our parents or caregivers, and these foundational experiences influence our attachments throughout our lives. There are two types of attachment: secure and insecure.​
Secure attachments are formed from reliable, loving, and supportive relationships with our caregivers in early life. Children who do not have safe, loving or supportive care or whose early attachments have been damaged may become insecurely attached. Most people who develop mental health problems have insecure attachment patterns.
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We work with residents to nurture positive relationships and build a secure base of attachment through a programme of one-to-one psychotherapy and therapeutic activities where all members of the community can spend time together in rewarding and enjoyable ways.
Containment
Containment is the feeling of belonging and safety, both physically and emotionally. It underpins all of our work. ​Everyone has a 'window of tolerance' for good mental health where they can manage stress and emotions. Those with broader windows adapt to life's ups and downs, while people who have experienced trauma may feel rigid or chaotic in similar situations. ​
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We support residents and staff in positive risk-taking and to manage their emotions in a healthy way, helping to empower them to recognise when they feel outside their window of tolerance and guide them back to a state of containment.
Exploration
The Exploration phase of recovery supports residents in (re) learning what they want from life and (re) discovering their potential within the CHT community and beyond.
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Exploration involves trial and error, courage, resilience, and curiosity, supported by the community's safe and nurturing environment. For some, it may include cooking a meal for the community or shopping alone; for others, it may involve pursuing new hobbies or finding a job or volunteering opportunity.
This crucial phase builds greater self-awareness and self-agency, ultimately leading to Autonomy.
Autonomy
Autonomy is usually the final stage of growth for our residents. At this point, they will acknowledge their interdependence and develop the self-agency to make decisions that balance personal needs with fairness to others. Residents will become active community members, supporting peers, volunteering, and engaging in various work or study opportunities.
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While Autonomy is a celebration of progress, it also often brings feelings of loss around friendship and identity.
Staff are crucial in this transitional phase, offering support as residents navigate the emotional challenges of moving away from a familiar community.