Complex Needs Service - Cheshire East

We are a specialist community-based service offering a range of psychological and social interventions for adults who may attract a diagnosis of a ‘personality disorder’. Our service covers all of Cheshire East and we are based in Macclesfield and Crewe.

We work with adults of all ages who, due to life experiences, have developed ways of coping and surviving which may have been helpful during times of difficulty, but which may also result in some unintended consequences that impact on their day-to-day functioning.  A person may typically develop difficulties such as:

• Making and maintaining healthy relationships
• Managing emotions
• Struggling with impulsive behaviours

These difficulties may impact on all aspects of daily life and across a variety of contexts.

Assessment

If the service is seen as a good fit, an initial meeting will be offered to the person with our staff (up to two practitioners). We offer up to six sessions of collaborative assessment in order to gain an understanding of the current difficulties and needs. The aim of this process is to develop an understanding of what has happened, what may still be happening and how we work to consider all of this. This is sometimes called a ‘psychological formulation’.

During these sessions, we will also develop a safety plan, along with outcome measures (these assess to see any progress or changes that occur and to see whether what we do is effective), and consider any reasonable adjustments (such as adjustments and adaptations / support for hearing, sensory difficulties) and relevant screenings (for example, alcohol and substance use).

Following the initial sessions, further interventions from the team may be offered, or the person may be signposted to other services who can best meet their needs.

Interventions

We currently offer evidenced-based psychological interventions which include Structured Clinical Management (SCM), Dialectical Behaviour Therapy (DBT) and Mentalisation-Based Therapy (MBT). These therapies are approximately 12-18 months long. Clients will work with an individual practitioner and have regular / weekly 1:1 and group sessions. There may be an overlap in some of the treatments provided and our team will work with people to help identify the most useful treatment pathway for them. 

There are further opportunities available for complementary interventions such as social prescribing and psychoeducation. The interventions might take place in person or using video calls. 

Our groups can be accessed virtually or face-to-face at the Jocelyn Solly Resource Centre (Macclesfield). This is based on individual need and will be discussed together with your practitioner.

As a service, we also offer consultation for colleagues working with people who may have difficulties associated with a diagnosis of ‘personality disorder’. Consultations are offered to professionals working in Cheshire East who would like a space in which to think about how they can most effectively support people within their current services. We help contextualise people’s experience through trauma-informed understanding and psychological formulation.

We also offer training to other services/ agencies to increase knowledge, skills and understanding around working with people with complex trauma or difficulties associated with a diagnosis of ‘personality disorder.’

To access this service, please speak to your GP, healthcare professionals and/or key worker. They will be able to make a referral if they think our service can help and is appropriate to do so.

“I want to thank all of you within the team. I've had my last group session today and I can deep down say,  your team are amazing. From recognising my difficulties, to getting a diagnosis and correct medication I can't thank you enough! It has been hard at times but I can honestly say it has helped a lot.  Believe me I've had years to get someone understand me. Thank you all so much for all the support you have gave me.” Service user

“Before starting with complex needs I tried five different therapists and had been in and out of hospital for years. I felt like I was the only person in the world who struggled or felt the way I did. I had little to no hope for my future and didn’t have any faith left in services. Everyone at complex needs has helped to change that. Now I feel less alone in my difficulties, I have confidence and hope that things wont always be as hard as they have been. It’s not been easy, and I still have a way to go but I now have tools in my toolbox to help with that. Thank you for caring, for not giving up on me, and for helping me break the cycle of hospitalisation.” Service user