At Baldock Manor Hospital we offer a 20-day psychiatric placement to psychotherapists and psychotherapy trainees that need to meet UK Council for Psychotherapy (UKCP) requirements.

The aim of this placement is to enable trainees to gain an understanding and experience of working in a secondary care psychiatric hospital.

The 20-day placement at Baldock Manor Hospital offers trainees an opportunity to discuss their needs and identify any specific areas for personal growth and development.

Our most recent trainee had this to say about her experience, when writing to her placement co-ordinator at the Centre for Counselling and Psychotherapy Education:

“I really wanted to tell you about Baldock Manor Hospital and the amazing experience I had there.

Baldock Manor Hospital is a locked rehabilitation unit for adults with a range of psychiatric diagnoses, including schizophrenia, psychosis, delusional disorder, Korsakoff’s syndrome, dementia, personality disorders, as well as complex physical health needs. The hospital specialises in supporting patients presenting with challenging behaviour and with a history of non-engagement in treatment. They accept patients with forensic histories and also provide palliative care.

It is a small hospital, with a maximum intake of 45 patients. While I was there they were running at 60-70% occupancy. Because of this relatively small size, the placement offered me the opportunity to spend time in all the hospital’s departments and to gain insights into a broad range of aspects of hospital life and administration.

I was there at a very interesting time in the hospital’s history:

They were undergoing a huge administrative restructuring programme, so I had the chance to see various models for documenting risk assessments, care plans and patient records being tried and tested for ease and efficacy. I was able to sit in on the daily hospital management meetings, clinical governance meetings, ward rounds for all the different wards and with all the consultant psychiatrists (responsible clinicians), as well as the six monthly CPA reviews with the patient, their multi disciplinary team at the hospital, care co-ordinators from the funding body, family members and sometimes members of the police force, if they had a forensic history.

They opened a psychiatric intensive care unit (PICU ward) for patients from other psychiatric hospitals who are experiencing acute symptoms and need to be stabilised. I had the opportunity to spend time on this ward, both at ward rounds and interacting with the patients. It was quite something to witness patients being admitted in a state of acute agitation and distress and subsequently improving to the point that they were calm and could reflect on their experience. I found it both emotionally uplifting and humbling.

The psychology department, and in fact the placement, is run by principal psychologist, Dr Elena Arora. She undertook her Phd in counselling psychology at Metanoia and is a psychotherapist at heart. She is herself a member of the UKCP and has a clear understanding of the placement requirements. Her background in psychotherapy gave us a common language and understanding to discuss patients and their treatment. It also gave me a valuable insight into the crossover between psychology and psychotherapy and the ways in which psychological assessments are invaluable tools in assessing risk and in understanding the patient’s psyche and behaviour, particularly when their mental health prevents them from being able to engage in self-reflection and therapy.

The psychology department was in the process of expansion, despite funds and resources being limited. I was there at the point that Dr Arora was developing both a therapeutic programme and team; building the skills and confidence of the activities co-ordination team such that they could deliver low intensity psychological interventions, through 1:1 sessions and mindfulness groups alongside their programme of activities within the hospital setting and out in the community. She was also in the process of appointing several assistant psychologists and I was privileged to be invited to sit on the interview panel together with her and one of the patients.

I was able to participate in music therapy sessions, the music appreciation group, book club, flower arranging and art sessions as well as going out in the community with patients and staff for social activities. With the patients’ permission, I was also invited to sit in on their individual therapy sessions with Dr Arora and to attend supervision sessions with the psychology team staff. I found this part of the programme both inspirational and a valuable learning experience. I saw excellent team building and management style modelled, as team members became excited at their new briefs and developed the belief that they could deliver them. I saw them being encouraged and supported in such a way that they could develop their potential and capacity without feeling overwhelmed. I myself felt supported, validated and encouraged throughout the placement. I was supervised by Dr Arora on an ad hoc basis, with almost daily check-ins together with ongoing reviews of how the placement was going and the goals for learning achieved.

In addition to attending all the meetings, ward rounds, activity and therapeutic sessions and patient contact, I had the opportunity to shadow: the assistant clinicians (doctors responsible for the patient’s daily psychiatric care), the social worker, patient advocate, principal psychologist, physical health lead nurse, ward nurse and support workers. This gave me a tremendous insight into what each role entails but also how these roles link with each other to best meet patients’ needs.

The placement provided the opportunity to gain a working knowledge of the Mental Health Act (MHA), its various sections and their implications in terms of treatment and documentation. This came about through being present while admissions, discharges and tribunals were being discussed, planned and prepared for, as well as by spending time in discussion with the Mental Health Act Administrator. I first read the MHA, its Code of Practice (CoP) and the CoP Guiding Principles and then saw the hospital staff working to put them into practice.

In observing the day-to-day running of the hospital, I gained an insight into the often complex relationships between service providers, funders and users.

I spent 20 days at Baldock Manor Hospital over a period of two and a half months. I saw patients being admitted in a state of acute mental illness, I also saw patients, some of whom had been in hospital for many years, being prepared for discharge, either to less secure psychiatric units or back into the community. This reinforced to me just how long it can take patients to recover from serious mental illness and, at the same time, gave me a sense of hope. I saw how important continuity of care is to the patients, how much they value their relationships, particularly with staff and how the quality of those relationships and the willingness of the staff to engage on a human level with patients has a material affect on their daily quality of life and on their possibility to heal.

Despite being over worked, under resourced and put under enormous pressure to meet administrative requirements, staff meet patients’ needs with compassion, kindness and respect. This is evidenced not only in their daily interactions but in the fact that despite being detained, often unwillingly, so many patients are happy to call Baldock Manor, ‘Home’.

I can recommend this placement highly for any student wishing to have a truly immersive and global experience of a psychiatric hospital. It would not be suitable for someone box ticking hours as the placement runs over 20 days and provides in excess of 160 hours. Days at the hospital run from 9am-5pm but there are times when you start at 8am and finish after 6.30pm. There is some degree of flexibility around the days that you attend and a great deal of flexibility around meeting the student’s particular needs and interests. This is a bespoke, high quality placement in every respect.

Dr Arora is keen to develop the placement programme further and for the hospital to gain a reputation for excellence in the field of educational placement provision.”