Beacon House offers a specialist trauma and attachment service for adults who have survived trauma, loss and disruption.
There are three clinical difficulties that we assess for, and treat:
Our trauma therapists come with extensive experience of working sensitively and effectively with individuals who have experienced trauma and adversity. We draw on a range of creative and evidence-based interventions to do this.
Our Adult Trauma Clinic is somewhat different from our Adult Clinic, in that we do offer a diagnosis in line with the most up to date diagnostic guidelines (The International Classification of Diseases – 11th Revision). There are some important reasons for this:
What is Post-Traumatic Stress Disorder (PTSD)?
PTSD is a collection of difficulties that may develop following exposure to an extremely threatening or horrific event, or series of events. It is characterized by all of the following:
To meet diagnostic criteria for PTSD, the difficulties above will have been happening for at least several weeks, and will be causing significant difficulties in personal, family, social, educational, occupational or other important areas of life.
What is Complex Posttraumatic Stress Disorder (C-PTSD)?
C-PTSD is a collection of difficulties that may develop following either exposure to harm and threat that shouldn’t have happened the absence of care and protection that should have happened. Usually, these events will have taken place repeatedly, over a long period of time and often during childhood. Escape from these events will have been difficult or impossible.
Examples of the types of experiences that may result in C-PTSD include childhood sexual, emotional or physical abuse, torture, slavery, genocide campaigns, and prolonged domestic violence. Trauma through the experience of an absence of care and protection might include growing up in a home with emotionally unstable or unavailable parents or carers.
In addition to experiencing all of the features of PTSD, individuals with C-PTSD will also experience severe and persistent difficulties with:
To meet diagnostic criteria for C-PTSD, the difficulties above will have been happening for at least several weeks, and will be causing significant difficulties in personal, family, social, educational, occupational or other important areas of life.
What are Dissociative Disorders?
Dissociative Disorders occur alongside complex forms of trauma, and range from experiences of Depersonalisation and Derealisation, to Dissociative Identity Disorder.
Depersonalization and Derealization
Depersonalization is a phenomena whereby people experience themselves as feeling strange or unreal. They might feel detached, or as though they are an outside observer of their own thoughts, feelings, sensations, body, or actions.
Derealization is a phenomena whereby people experience others, objects, or the world as strange or unreal (e.g., dreamlike, distant, foggy, lifeless, colourless, or visually distorted) or they feel detached from their surroundings.
Dissociative Identity Disorder (DID)
Dissociative Identity Disorder occurs when a person has been exposed to such severe and persistent harm, that their mind has protected itself by creating separate parts to contain overwhelming and traumatic memories, thoughts, feelings and body sensations. This results in a disruption of a person’s identity, where a person has two or more distinct identities.
The different identities regularly come to the fore, and take control of the person’s thinking, behaviour, interaction with others, and interactions with the world around them. Changes in identity come with changes in senses, perception, mood, thinking, memory, body sensations and body movements. Usually, individuals with DID have no memory for the time that they have been in one of their separate identities.
From our experience, individuals who make an enquiry at Beacon House have often struggled to access specialist assessment and intervention for PTSD, C-PTSD and DID. We know that accessing this specialist care is a priority, and often urgent, need. We do our very best to balance this need with our clinical and ethical judgement of how Beacon House can most meaningfully, effectively, and sustainably contribute to your long-term healing and safety.
There may be times when we will not accept a self-funded referral on clinical and ethical grounds, and we will always be absolutely transparent with you about our reasoning and rationale, and let you know what choices and options you have.
To make an enquiry and find out more, you are welcome to call us on 01444 413 939 (for our Cuckfield clinic) or 01243 219 900 (for our Chichester clinic). You are also welcome to email us on [email protected].
Our Referrals Team are warm, compassionate, experienced and sensitive. The information that they take from you over the telephone will help us to know what the most appropriate next step is.
Some adults feel anxious, unsure or overwhelmed about contacting us directly. We are happy for relatives or friends to make the initial contact with us, but if you are over 18, we will need to have some indication of your consent to the referral before we can progress it. This might involve you being present with your relative or friend when they contact us, or sending an email to our referral team.
We offer two different types of assessment in the Adult Complex Trauma and Dissociative Disorders Clinic, and our Clinical Lead will first consider which route of assessment is most suitable for your needs.
Our brief assessment involves 2-4 hours of face-to-face assessment appointments and leads to a detailed therapeutic letter outlining our formulation, diagnosis and therapeutic recommendations. This assessment can be self-referred and self-funded in most circumstances.
Our alternative pathway is an extended therapeutic needs assessment which involves a more comprehensive exploration of your difficulties and needs, liaison with your network and the development of a formulation, diagnosis and therapeutic recommendations.
The type of assessment that we offer you will depend upon:
For individuals who live outside of our area and who have complex needs which require our extended therapeutic needs assessment, we recommend that you approach your GP and request that they make an Individual Funding Request to the Integrated Care Board (previously Clinical Commissioning Groups) for your area. Beacon House is currently used by 5 ICBs in the South of England via Individual Funding Request.
We are open to developing partnerships with ICBs throughout England, and we welcome enquiries from commissioner colleagues.
After you have spoken to our referrals team, your information is shared with our Adult Services Clinical Lead who considers which type of assessment is most suitable for your needs. Our Clinical Lead may request a 30-minute telephone conversation with you to gather more information to help us decide our next steps. Please note that the decision about which assessment is suitable for you is a clinical decision based on the information available to us, made and held by our Clinical Lead.
If we can offer you a self-funded therapeutic needs assessment then our Clinical Lead will allocate you to a therapist in the team who has the right expertise to offer both the initial assessment, and ongoing therapy, if you choose to go ahead. Our Referrals Team will then get back in touch with you and provide you with an estimate for your assessment. If you choose to proceed, you will be asked to make payment in advance for the assessment, and then you will be offered an initial assessment date, which will be confirmed by letter.
If your GP agrees to make an Individual Funding Request to the ICB, we will provide the necessary information about Beacon House, including details of our regulation, governance, and costs. The completion of the relevant documentation, submission to ICB and consideration can take a number of months, so it is important to be prepared for this. Once funding is agreed, we will allocate you to a specialist therapist in the team who will undertake your assessment, and possibly therapy if that is recommended and funding is agreed.
When you arrive at Beacon House, you will be welcomed by a member of our team and shown into our comfortable waiting room. We know that it can feel overwhelming or unsafe for some people to wait in shared spaces. Therefore, we have a couple of seats in our quiet lobby area, close to the entrance / exit.
If you are feeling distressed or unsafe when you arrive, please tell a member of our administrative team, who will make your therapist aware and will make every effort to help you to feel assured whilst you are waiting.
You will be offered a hot drink, and you are welcome to help yourself to water and healthy snacks. Your therapist will come and meet you at the time of your appointment.
Our initial assessment aims to develop a psychological ‘formulation’ of your difficulties. This involves developing an understanding of:
All of this information is then brought together, underpinned by psychological theory and research evidence.
We will gather most of this information by simply speaking with you, and guiding you to tell us your story, in your own way. To enable us to give you a diagnosis, we will ask you to complete some questionnaires with us.
Many people are concerned that they are going to be asked to speak in detail about very difficult and distressing matters, having only just met their therapist. We acknowledge the courage that it takes for people to walk through our front door, and our priority is keeping you safe while you are here. Your initial assessment helps us to get an overview of what is troubling you, and it is not necessary for you to make yourself feel vulnerable by sharing more information than you feel ready to. Alternatively, you may have been needing to speak to someone for a long time, and you might want to tell your story in full at your first meeting with us. We will adapt to what you need.
Adults have told us that our assessments often shed new light on the problems they have brought to us, which can create change and hope early on in our work with them. We see the assessment as the start of treatment, because understanding the difficulties is always the first step towards healing.
For self-funding assessments, your assessment letter will be ready within four to six weeks of the last assessment appointment. This letter will include our formulation, and detailed recommendations for the type of therapeutic intervention that we think would be most helpful. With regards to your assessment letter, please discuss your specific preferences with your allocated therapist; for some clients, it is important to have a recorded narrative of important life experiences, whereas other clients prefer a more technical, clinical letter.
If required, we will be happy to invite you to come back to meet with us face-to-face, where we will support you to hear our formulation, talk you through our recommendations, and answer any questions that you have about the course of therapy that we are suggesting (this meeting is charged at one additional session cost of £120). You can then choose to take up the therapy or not – there is no obligation.
For ICB funded assessments, your assessment report will be ready within four to six weeks of your last appointment. We will first go through the letter with you, and once you consent for it to be shared we will then send it to the ICB and your GP. We usually recommended long-term therapy, and we provide the ICB with an estimate of costs for their consideration. It is important that you know that there is no guarantee that the ICB will commission Beacon House to offer the recommended therapy; they may wish to consider a range of providers.
If an application is made the ICB to commission Beacon House to offer therapy, unfortunately, we are not able to offer you ongoing support or therapy whilst we await confirmation of funding. There is a pause in our relationship with you until we are clear that we have the funding agreement and permission to continue working with you. Once permission has been given to us by the ICB, we will get back in touch with you and arrange for therapy to begin as soon as we have availability with a suitable therapist.
At Beacon House, all of our work is ‘attachment informed’. This means that we play close attention to the role of emotional and psychological connectedness between human beings. Every adult that we see at Beacon House has, of course, been an infant, a child, and an adolescent. The ‘attachment relationship’ between an infant and their caregiver during the early years of life has a lifelong impact upon all aspects of childhood development – emotional, social, psychological, neurological and physical. This creates a pattern for how we feel about ourselves, about other people, and about how the world works. It impacts on how we experience life’s challenges and adversities.
We are inspired by the work of Laurel Parnell and Kathy Steele, who have written extensively about the key role of attachment and phase-work in recovery from all forms of trauma. Therefore, the following values underpin all of our work in the Adult Trauma Clinic:
1. Safety
We carefully assess your readiness for each stage of therapy. We prepare you emotionally, psychologically and physiologically for every therapeutic task. We ensure that you feel comfortable in your therapy room, and that you have everything that you need around you during sessions. We ask you what you need in order to feel safe. We stand alongside you, without judgement or assumption.
2. Healing through the therapeutic relationship
We dedicate time and energy to developing a relationship with you that feels safe and secure. We are warm, down to earth, and completely honest and transparent. We will offer you an appointment at the same time each week and will always give you adequate notice if we are going to be away.
3. Client-centred practice
We respect your agency, your autonomy, and your right to choose. We trust in your inherent ability to heal, and we are led by this, as facilitators of this process. We are open and curious, and happy to receive your feedback about what you need from us. Our approach is collaborative, with your voice right at the centre of everything that we do.
4. Resourcing
We believe that everyone has parts of themselves that are pro-healing, courageous and compassionate. It can be difficult for people to connect with these capacities within themselves when all energies have been directed towards surviving adversity. At the beginning of therapy, and often throughout the course of therapy, we dedicate time to connecting with these resources, and strengthening them.
5. Flexibility
Our therapists offer evidence-based interventions that have proven effectiveness for all forms of psychological trauma. We are fortunate in that our therapists are expert enough to integrate techniques from a number of different psychological therapies in order to match your needs. We do not deliver therapy in a manualised or rigid way. If client and therapist do not feel that a certain approach is meeting the client’s needs, we pause, review, and select a different approach.
It is difficult to describe a ‘typical’ course of treatment in the trauma clinic, as each individual is unique, and your treatment will be tailored specifically to your needs. However, the outline below gives a general overview of the phases of treatment for PTSD, C-PTSD and Dissociative Disorders. The pace, and length, of treatment depends entirely on what is safest for you. You can expect to regularly think together with your therapist about your experience of therapy, and how therapy is integrating with your life outside of therapy. Contrary to some popular opinion, whilst trauma therapy can at times feel quite emotionally intense, there is no therapeutic value in confronting levels of distress that leave you feeling uncomfortable or unsafe between sessions.
Here is a typical sequence of trauma informed therapy:
1. Assessment and Formulation
2. Treatment Planning
3. Education
We will introduce you to the research evidence, which tells us how trauma impacts upon the mind and body. We will help you to make sense of your symptoms, giving you a psychological, neurological and physiological explanation for all of your symptoms. We find that this understanding helps clients to feel more informed, less vulnerable, more in control, and less frightened and confused by their symptoms.
4. Stabilisation
We help you to address any factors in your life that might be inadvertently exacerbating your symptoms. We will teach you strategies and techniques to tolerate and manage intense emotions.
5. Resourcing
We believe that every client has parts of themselves that are pro-healing, courageous and compassionate. It can be difficult for clients to connect with these capacities within themselves when all energies have been directed towards surviving adversity. At the beginning of therapy, and often throughout the course of therapy, we dedicate time to connecting with these resources, and strengthening them.
6. Creating Safety
Throughout therapy, individuals with C-PTSD and/or DID benefit hugely from a professional and personal support network. If you are under the care of an NHS Secondary Care Mental Health Team, we will develop a close working relationship with them, and will communicate regularly so that they can support you and keep you safe outside of therapy sessions. We will also help your family members or friends to understand how to support you. If you, or your dissociative ‘identities’, sometimes cause harm to yourself when distressed, we will develop a safety plan jointly with you, any other professionals involved in your care, and your personal support network.
7. Processing traumatic memories
This stage helps your mind, body, and nervous system to learn that the threat and danger is in the past. The goals of this stage are to reduce the occurrence and intensity of your trauma symptoms, and thus, the impact of these symptoms on your day to day life.
8. Integration and future planning
This stage is focussed on continuing to move towards healing, recovery and resolution. This is a deeply individual and personal phase. It may include acceptance, forgiveness, spirituality, confrontation, redress, justice; whatever is required by each individual in order to move towards a peaceful and fulfilling life.
The main psychological models that we use in the Adult Trauma clinic are:
Therapeutic progress is something which is continually reviewed throughout the intervention. During the assessment, your therapist will make a plan with you about how many sessions should take place before a more formal ‘pause and review’ appointment is offered.
Alongside this, we have three main ways that we evaluate your therapeutic progress:
We understand that taking that step towards asking for help takes courage. We also understand that it can feel like a step into the unknown. Take a browse through our Testimonials where you can read what other clients have said about their journey through therapy here at Beacon House.
If you have any questions about our services please feel free to pick up the phone to us on 01444 413 939 or send us an email on [email protected], we welcome informal conversations about whether we are the right service for you. To make a referral please click here.