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Treatment Overview At Tyrwhitt House

Discussions and general chat about PTSD. Feel free to introduce yourself or if you need help, please reach out and ask.
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harry hackedoff
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Joined: Tue 19 Feb, 2002 12:00 am

Treatment Overview At Tyrwhitt House

Post by harry hackedoff »

Following on from the visit to Combat Stress at TYRWHITT HOUSE on September 13th, 2002, this is my report on the treatment process from referral to the end of a two-week stay and beyond. It is based largely on an interview with the Clinical Manager, Tony Letford and talking to staff and patients.

To start with how people get referred to Combat Stress, either for an assessment for PTSD or for treatment itself. Most referrals are by GP. See your GP, tell him your symptoms and asked to be referred to Combat Stress. Others may be referred by SSAFFA or RBL. Some people will simply ring C.S direct and ask to talk to somebody about PTSD and will thereby "self refer".

From any of the referral routes, one of the eleven Regional Welfare Officers will arrange an appointment to meet you. The Welfare Officers are not medically trained but are all ex-services. Their function at this stage is to produce a report which goes to Tony Letford who then decides on an assessment or treatment at one of the three regional centres. Each centre has its own geographical catchment areas, one for the South of England, located in Leatherhead, one for the North located in Newport, Shropshire and one for Scotland and Northern Ireland located in Ayr. Treatment can be funded from various sources.
Either the WPA (Veterans Agency) will fund treatment or if you do not (yet) have a war pension, then SSAFFA or RBL will fund it. In the rare cases where none of the above agencies will fund treatment, then C.S will pay for it themselves. You don't have to worry about who is going to pay, the Welfare dept at C.S sort that out. C.S's view is that if you need treatment then you will get treatment. The Welfare Dept can arrange housing for homeless sufferers whilst they wait for a date to attend one of the treatment centres. They can also arrange for de-toxification for those with alcohol or drug problems before attending. The WPA will only fund six weeks attendance within any one year, either 6X1 or 3X2 or 2X3 weeks and once you have have been given a date to attend you will receive a " joining instructions" letter. This will suggest what clothing to bring. P.T. rig, for instance, as they have a gym if you want to use it. The use of alcohol is not permitted between 9-5, but moderate drinking is allowed outside these hours. No alcohol is permitted on site but you are free to come and go as you wish. At Tyrwhitt House, for instance, there is a golf club nearby which welcomes patients. Intoxication may result in you being asked to leave, so be warned. Certain people will be asked to limit the amount of alcohol that they consume or even abstain altogether. Alcohol can react with certain medications and thereby interfere with treatment. If you come back on board shit faced, it is extremely disruptive for everyone else and the rule is that you will be asked to leave. The use of drugs is not condoned and if found then you will be asked to leave.

On average 4-5 people arrive for treatment each day. With similar numbers leaving each day the "population" is constantly changing and this means that there is always someone with more experience of the treatment process that you can turn to for help/advice among the patients. Outside of working hours there is no organised treatment, but being able to talk to other sufferers is extremely beneficial. These late night "chats" can often go on till the early hours.

That takes you from referral to arrival. Next, I want to talk about a typical two-week stay. The first week is mainly taken up with assessments to decide on treatment needs. This is a two way street as you will also be assessing them. During this time there will introduction to anxiety management and other therapies. Art therapy is extremely useful and you will have several one to one sessions with the art therapist. Most find this very beneficial. The use of rapid eye movement desensitisation therapy is practised at some centres and has a mixed success rate. Some guys do not get on with it and some find it very helpful. Cognitive behaviour therapy is a common treatment process which involves setting small goals. For instance, a baby cannot get up and sprint 100 metres. It has to learn how to crawl, how to start to walk, and then finally run. Put simply, you can't cure all your symptoms in one mighty bound, you need to learn how to crawl first, then stand etc. The second week is more intensive. But contains the same elements as week one, without the assessment periods

Finally, there are the group sessions where you can simply sit and observe, if you do not feel able to join in. All of the patients that we spoke to felt this was the best part of treatment. There is also occupational therapy. There are many activities available in the occupational therapy room e.g wood work, model making and we saw some excellent examples of work produced by former patients.

Nursing cover is now 24 hours and the Shropshire unit has therapy sessions for 7 days. At T.H., this is for 5 days with organised trips or activities for the rest of the week. These may vary from places of interest to shopping at Tesco, If you haven't been outside of your front door for 2 years then going to Tesco is quite an achievement.

There is no restriction on visitors, apart from during 9-5 which is the working day. Some guys do not want visitors as they may need space away from the family. Others live too far away to visit. Guys who want to and live near to a centre, can have visitors every day.

The food is basic and wholesome. Not every body likes every meal, but there are usually alternatives.

The accommodation is in single rooms with bed, wardrobe, chest of drawers, desk, chair and basin. All very clean and in good condition. There are showers and baths available. There are television rooms, a library and a games room. Smoking is permitted but only in certain areas.

Every two weeks there is a clear lower deck drip session for everyone to air any aspects of their stay that they are not happy with. The centres are not military establishments and you will be treated as an individual, always with respect. When you arrive you will be assigned to a key nurse. You can refer to this person whenever you like and you will have several sessions with them. They will explain/discuss treatment types and methods. At the end of a period of treatment the key nurse will produce a "discharge statement" which you will get a copy of. As a copy goes to WPA/VA for funding requirements, then ensure you keep your copy. A copy goes to your GP. This discharge statement also goes to the clinical manager and from this future treatment needs or medication are planned.

There are no compulsory treatment sessions, you are free to attend them or not. It was pointed out by a staff member that patients who don't take part still benefit simply from being in the company of fellow sufferers. However, we were told by one of the guys that your stay at a centre will be what you make it. The more you put in-the more you get out.
The welfare department will advise families and partners about PTSD and how to recognise the early onset of a panic attack, for instance. There is a family support group and this has links with R.B.L. The Welfare Officers will also offer support to sufferer’s families.

Finally, to talk about success rates is a difficult one as the severity of symptoms varies from one individual to the next. The main aims of treatment are to teach you how to manage and reduce your symptoms and to start getting your personal relationships back on track. If you have taken ten years to develop the symptoms of PTSD, then it will take more than a two week stay to sort it out. All of the guys we spoke to said they were glad they had come for treatment and found their symptoms reduced.
It is a gradual process and again, the number of visits required will vary from person to person.

If you have any questions about any aspect of what I have written, then please contact any of the Listener group

Good Luck.

yours, Aye

Harry
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