Structured Clinical Management (SCM)
What is Structured Clinical Management (SCM)?
Structured Clinical Management (SCM) is an evidence-based intervention for people who have symptoms consistent with Emotionally Unstable Personality Disorder (EUPD).
Emotionally Unstable Personality Disorder is a diagnostic term used in mental health services. It acknowledges that for some people aspects of their personality can significantly restrict their quality of life.
Although EUPD is associated with enduring difficulties, with the right help and support we now know that most people with this diagnosis can get better.
Is SCM right for me?
If you have difficulties around:
- Impulsivity (acting without thinking)
- Managing relationships
- Problem solving
- Managing emotions
- Meet criteria for a diagnosis of emotionally unstable personality disorder (may have other diagnoses as well)
- Would like a life outside of mental health services
Then SCM may be helpful for you.
What help can I expect from SCM?
SCM involves three phases; an introductory phase involving work with an individual SCM practitioner, an intervention phase which involves individual and group work and an ending phase with your individual practitioner.
Initially, your SCM practitioner will work with you to go through:
- Your diagnosis
- Develop a crisis plan
- Help you identify problem areas
- Help you define your goals (short and long term)
- Advocate for you
In the intervention phase they work with you to help you develop knowledge and skills to meet your goals by focusing upon:
- Problem solving
- Understanding and managing strong emotions
- Understanding others and managing relationships
SCM involves weekly forty five minute individual appointments that will usually take place on an outpatient basis. The appointment will focus on current difficulties you are having.
The evidence suggests that groupwork is crucial to giving you the best chance of improvement.
Your SCM practitioner can work with you to help you attend the group component of the intervention.
The group occurs weekly lasting one hour thirty minutes. It focuses on here and now problems and goals including themes in the areas of difficulty referred to previously.
At the moment there is no medication that is proven to treat emotionally unstable personality disorder. You may be offered medication for other related problems.
What is the commitment for SCM?
You will be in the SCM intervention programme for up to 100 weeks. There is also an ending phase following completion of SCM.
In SCM you are required to complete brief questionnaires; this helps you and us monitor progress.
What about hospital treatment?
The most effective treatment for EUPD occurs in the community.
If hospitalisation is required it is recommended that the admissions are short and are focused on a clear goal. For example, an admission may be for assessment (to try and understand what could be causing the current difficulties). Or it may be to help stabilise an acute crisis, for example, by establishing or revisiting a crisis plan or a community care plan.