The purpose of Occupational Therapy is to enable people to fulfil, or to work towards fulfilling, their potential as members of the community. Activity can be an effective medium for remediating dysfunction, facilitating adaptation and recreating identity. In line with many other Occupational Therapy services working in mental health settings the Occupational Therapy team at the Langford Centre have chosen the Model of Human Occupation (MOHO) (Kielhofner, 2008) as the main theoretical framework to guide their practice.

Occupational Therapy assessments include:

• The Model of Human Occupation Screening Tool (MOHOST),
• Occupational Circumstances Assessment Interview
• Rating Scale (OCAIRS)
• Sensory Profile

On admission an Initial Occupational Therapy assessment is completed and an Interest Checklist. When nearing discharge an Activities of Daily Living assessment is sometimes indicated to recommend what support may be needed for the individual in the community. The Occupational Therapists are also able to assess mobility needs and the risk of falls.

Individual Occupational Therapy is identified from assessments or referrals from the MDT team. The intervention is tailored to individual needs maintaining an occupational focus and this may include self-care, leisure and productivity. An intervention plan will be created in collaboration with the person and goals set and reviewed. Possible interventions may include independent living skills assessments and interventions, sensory assessments and strategies, and supporting people to engage in meaningful activities.

People that access our service have the potential to present with physical health conditions as secondary issues. As part of this there may be a requirement for a physical health Occupational Therapy assessment. A physical Occupational Therapy assessment can address general strengthening, adjusting wheelchairs, recommending adaptive equipment, or any other task that is within the scope of Occupational Therapy.

All groups are evidence based and designed to support people with skills and strategies to manage their wellbeing, promote independence and create roles and routines.

The groups are designed to be interesting and are reviewed regularly dependant on service user requests and interests.

Groups are used to assess motivation, appraisal of ability, interests, roles and routines. Communication, interaction skills and process skills are also observed which entail timing, knowledge, sequencing and problem solving. Groups can also provide information on fine and gross motor skills, energy levels and posture. Occupational Therapists also observe how the person navigates their physical and social environment.

Due to the design of the acute service being a short admission, intense psychological therapies focussing on trauma such as a full in depth DBT programme, are not suitable to be started within the service. The psychology department are able to provide a variety of other interventions to support individuals during their admission and prepare for more intense psychological interventions.

The psychology department are able to complete a number of Assessments and Screenings:

Cognitive assessments:

• The MoCA (Montreal Cognitive Assessment) is a short, standardised screening test used to detect mild cognitive impairment (MCI) and early signs of dementia.
• The ACE-III is a cognitive screening tool used to assess a person’s thinking abilities.
• ADHD and ASD screenings:
• The Conners’ Adult ADHD Rating Scales (CAARS) is a standardised psychological assessment used to evaluate ADHD symptoms in adults (ages 18–59).
• The RAADS-R is a self-report psychological assessment designed to help identify Autism Spectrum Disorder (ASD) in adults.

Once these screenings are completed and scored, a referral is then made to the NHS waiting list for a formal diagnostic assessment.

The Psychological Interventions offered within The Langford Centre for individuals admitted to the acute services include:

Brief, focused psychological contacts are offered on a weekly basis to service users with the aim of building therapeutic rapport, assessing psychological and neurodevelopmental needs, and providing targeted support. Formulation considers presenting difficulties alongside predisposing, precipitating, perpetuating, and protective factors, allowing for a holistic understanding of each individual’s needs. Interventions include the use of psychoeducation, and skills training in areas such as emotional regulation, problem-solving, and social communication, alongside supportive strategies such as motivational interviewing and solution-focused techniques. Where appropriate, service users are signposted or referred to specialist services to ensure comprehensive care and continuity of support.

8-session group with practical tools to recognise, manage, and recover from crisis. Combining CBT, DBT, and mindfulness-based strategies, each session focuses on skill-building through interactive activities. Topics include identifying crisis triggers and cognitive distortions, problem-solving, emotional regulation, distress tolerance, self-soothing, mindfulness, and effective communication. Service users gradually build a personalised Crisis Management Plan (CMP) throughout the program, promoting autonomy and relapse prevention.

Provides brief support for service users experiencing emotional distress, needing support, or seeking coping strategies. Sessions are offered once a week to all the wards with a solution-focused approach. Crisis planning with service users is a proactive, collaborative approach that ensures individuals receive tailored support during emergencies. Plans are co-produced to reflect personal preferences, identify triggers and early warning signs, and outline preferred interventions alongside clear guidance for involving support networks and emergency services.

Mindfulness involves paying attention to what is happening both within us and in our surroundings, moment by moment. Developing greater awareness of the present can enhance our ability to appreciate the world around us and deepen our understanding of ourselves. On the ward, staff facilitate mindfulness exercises twice daily, with each session lasting approximately 10–15 minutes.