CAPE offer a wide range of support services.
View Cape Timetable
CAPE Outreach support is designed for clients who are particularly chronic in presentation and/or experiencing a profound crisis in their lives. For these extremely troubled clients, it would be unreasonable to expect them to engage with us by coming into our Cafe premises in Acton. Instead, their dedicated Outreach worker visits them at home, or meets with them out in the community (typically a library or local coffee shop).
The principal function of the Outreach worker is to prevent relapse which could lead to ‘in-patient’ care. Outreach support enables the client to introduce some structure and appropriate meaningful activity back into their lives. They offer the client much needed encouragement, hope, guidance and support, as well as practical problem-solving, issue resolution and coping strategies, as the client embarks on his or her recovery journey.
Initially, client and worker engage with one another for six months, after which an assessment is made as to whether the client is ready to move to CAPE Cafe Membership, or would be better served by receiving further Outreach support.
Outreach outcomes are monitored on a minimum of a six-monthly basis (more frequently, should this be judged necessary). Two different measurement tools are used for this. The vast majority of our outreach clients are monitored using the Recovery Star tool which comprises of ten scales, each with ten steps. The scales are built on a ‘journey of change’ model of the stages that service users go through in working towards independence. The information is recorded on a Star form which provides a visual snapshot of the shape of the client’s life at present.
The ten outcomes areas measured are:
Managing mental health / Self-care / Living skills / Social networks / Work / Relationships / Addictive behaviour / Responsibilities / Identity and self-esteem /Trust and hope
In addition to the Recovery Star, CAPE is piloting a second outcomes monitoring instrument with a small group of Outreach clients. The Recovery Assessment Scale (RAS) comprises of 41 questions and covers five factors: personal confidence and hope; goal and success orientation; willingness to ask for help; reliance on others; and no domination by symptoms. It enquires about the impact of symptoms, desires for the future and the use of other people to support recovery.
Cafe Social Forum
Loneliness is one of the most common feelings experienced by people living with severe and enduring mental illness. Many have been shunned by friends and family over the years as a consequence of those closest to them being unable and / or unwilling to cope with the demands that can be made on them by friends and family who are living with mental ill health.
Many CAPE clients’ feelings of profound loneliness can be exacerbated by the loss of self-esteem and self-confidence that can accompany the progression of mental illness and contribute to their social withdrawal. It is for this reason that the Café at CAPE is the central focus of the organisation around which all other aspects of our service revolve.
The café provides clients with a social forum, a place where they can come and meet like-minded people, people with whom they can share their struggles and fears, and their triumphs and joys.
The café is open from 11am until 5pm daily on Monday, Wednesdays and Fridays and attracts an average of 55 visitors a day. It has a warm atmosphere where clients feel welcome, can meet other CAPE clients, and feel a valued member of a supportive social community. It serves a hot, home-cooked two course lunch every day, as well as a range of hot snacks and drinks.
A member of the staff team is on-hand in the café every day to give clients advice and support, as well as monitor their overall wellbeing and spot any indications that a client might be becoming unwell and in need of additional psychosocial and / or medical support.
The feedback from clients, taken from our Annual Service Consultation Survey, is that the café is a place where they feel safe and supported. They also report that the café plays a vital role in reducing their sense of loneliness.
The activity groups programme at CAPE is always busy with an average of 20 groups running each week across the three days that the Café is open to clients.
The weekly activity groups timetable includes a mix of psycho-educational groups such as the Wellbeing group and the Sleep Clinic, as well as more general interest groups such as the News & Current Affairs Discussion Group, the Pop Choir and the Art Workshop.
There are also educational groups such as Numeracy & Literacy as well as groups such as the Slimming Group, Yoga & Fitness and the Walk for Wellbeing groups. These groups address key concerns for many CAPE clients, many of whom have Diabetes. Moreover, as a mental health support service we are mindful of the strong link between physical and psychological ill health. Another popular fixture on the weekly timetable is the very well attended Women’s Group.
We have introduced an Adult Education & Training Surgery to the weekly group timetable recently and re-introduced our previously very popular Social Activity Planning Group. Social isolation is an all too common experience for many CAPE clients, many of whom struggle to cope on the days that we are not open to them. This group goes a small way to addressing this as clients meet and decide on a social gathering of some kind that is undertaken the following weekend when CAPE is closed. The group has organised lunches in local restaurants as well as visits to nearby places of interest, and trips further away to Oxford and elsewhere.
Talking Therapy Groups
CAPE offers clients with severe and enduring mental health conditions innovative and effective counselling and psychotherapy. Our clients frequently find themselves excluded from receiving this kind of support as the majority of therapy providers regard our clients as too troubled in their presentation to usefully engage in such work. Our experience tells us that this assumption is false as we have witnessed significant changes in client wellbeing as a result of taking part in group therapy with us.
Our group therapy programme has expanded in the past year with the introduction of Strengths-based Cognitive Behavioural Therapy (SB-CBT). This is a type of therapy that runs in eight week blocks, ideal for many of our clients who struggle to commit to longer-term work.
Client outcomes from therapy are rigourously monitored and recorded using a range of different measurement tools. CAPE is part of the Ealing Talking Therapies Network, a forum for sharing best practice amongst other local therapy providers within the borough. Many of the measurement instruments adopted by CAPE are similar to those used elsewhere (such as within NHS IAPT). These include the GAD-7, PHQ-9 (both used weekly) and the CORE-34 (used quarterly). In the Hearing Voices group, client outcomes are measured using a modified version of the Hearing Voices Group Evaluation.
We also offer clients one-to-one psychotherapy. Clients see their therapists weekly for 50-minute sessions and the contract between therapist and client is ongoing, allowing the possibility for real in-depth work which addresses the root causes of psychological distress, as opposed to merely addressing the symptoms of such discomfort.
The four different group therapy options available weekly at CAPE are:
- Strengths-based CBT – this group focuses on building positive qualities and strengthening personal resilience.
- Behavioural Activation Therapy (BAT) – aimed at those with moderate and severe depression, the fundamental goal is to increase activation and engagement in one’s world in order to make life more rewarding.
- Hearing Voices – this group focuses on its members’ struggles with auditory, visual and sensory hallucinations, and their achievements in managing their symptoms.
- Recovery Group – this group focuses on allowing members to relate to others’ experience, reducing loneliness and increasing a sense of wellbeing through shared experience, improving cognitive patterns of thought.
Opportunities for Volunteering
The Volunteer Engagement Programme at CAPE continues to gather considerable momentum. The charity now has an average of 27 clients a week enrolled in this programme. We also depend on a small number of non-client volunteers who facilitate some of our most successful activity groups.
The time and effort that our army of volunteers give to CAPE is vital to our ongoing success as without their input, we would be unable to give clients access to the full range of services we provide. We are immensely grateful for everything our volunteers do for us.
The majority of CAPE volunteers work in our busy Cafe kitchen where they run a full Cafe counter service from 11am until 4pm. This service provides nutritious home-cooked food, including a two-course lunch (typically, 26 covers are served) as well as a range of hot and cold snacks and drinks throughout the day.
Experience tells us our hot lunch service is vitally important for our clients, many of whom lack the motivation, appetite and / or the skills to cook and provide regular meals for themselves. CAPE kitchen volunteers acquire and test their skills undertaking a range of different catering tasks including fresh food preparation, cooking, baking, washing-up, serving at the counter and handling cash transactions at the busy till. As well as working in the Cafe kitchen, CAPE volunteers provide vital office administration and back-up support to the CAPE staff team.
Our volunteers regularly tell us that their ‘best days in the week’ are the ones when they volunteer at CAPE as they feel part of a supportive team of paid and voluntary staff working collaboratively in a busy environment where the benefits of providing our service to clients are clear to see. By volunteering, they feel that life has some purpose, meaning and structure, making it easier for them to structure the rest of their time when they are not with us. For some clients, undertaking voluntary work at CAPE is the catalyst they need to go further and consider seeking paid employment.
Benefits and Financial Planning 1:1 Support
Experience tells us that managing welfare benefits and keeping on top of bills and other personal finance issues can feel utterly overwhelming for many clients with severe and enduring mental health problems, particularly those who suffer from anxiety conditions.
This part of CAPE’s service is run in conjunction with our partners Pathways Project.
The service provides a range of support advice, information and signposting sessions on non-clinical but vital issues such as employment, welfare benefit and financial issues, housing, debt management, peer support and volunteering. Where clients have no money for food or electricity due to debt or benefit sanction, Pathways can provide them with Food and Tesco vouchers to help stabilise and sustain them until their issues are resolved.
The demand for benefits, financial and housing advice from CAPE remains high. Many of our clients have experienced having their benefits stopped (either temporarily or long-term), or taken away altogether, both of which can be harrowing and halt any recovery in its tracks. Understanding the welfare benefits maze and accessing the right information, can feel like navigating a minefield. And clients look to us to give them the skills they need to feel equipped to take on the task of managing their affairs in this vitally important area.
Clients who are in crisis look to us for advocacy. We work on their behalf to achieve the right support and outcomes for them. Clients can dip in and out of crisis in rapid succession. We believe that providing the right kind of skilled advocacy and support in times of crisis can be the key ingredient in ensuring that any crisis endured is short-term rather than long-term, and thus less debilitating in nature.