Complex emotional and relational needs pathway

People with complex emotional and relational needs (CERN) have difficulties managing their emotions safely, may struggle with making and keeping healthy relationships, and have difficulties with impulse control. 

These difficulties cause a lot of distress for you and your loved ones. We have developed a number of services to deliver evidence-based psychological treatments if you have complex emotional and relational needs.

Previously if you had these needs you may have been diagnosed with 'personality disorder', but you don't need a diagnosis to make use of these services.

The pathway is here if you have significant difficulties in emotional regulation and interpersonal relationships, and you are open to secondary care services.

Some of these psychological services have a team or base in each of Pennine Care's five boroughs, while some have one team covering them all.

Please see each service webpage for details on how to be referred.

The waiting times may vary and for some treatments this can be quite long. If you’re finding this difficult to manage please speak to your care coordinator. Or if you are not under secondary care mental health services, please speak to your GP. You can also contact our 24/7 crisis mental health helpline.

Each borough has a secondary care psychology service.

These services offer individual assessment and treatment options, such as:

  • Cognitive behavioural therapy (CBT)
  • Eye movement desensitization reprocessing (EMDR) therapy
  • Clinical psychology
  • Cognitive analytical therapy (CAT)

Click on your borough to read more and see what support is available:

Each borough may have a slightly different offer and waiting times can vary between services and boroughs.

Structured clinical management is an evidence-based intervention which may be helpful if you have difficulties with: ​​​​​​

  • Making and keeping healthy relationships
  • Managing emotions and mood
  • Impulsivity (managing urges to act quickly)
  • Self-harm and suicidal thoughts

We offer one to one sessions to get to know you and understand your difficulties.

Our team will work with you and help identify the most useful treatment option for you. If you continue with the structured clinical management full program, this consists of weekly group and one to one sessions, teaching you skills in:

  • Problem solving
  • Understanding and managing emotions and mood
  • Understanding and managing behaviours that put you at risk
  • Understanding and managing relationships.

Each borough has it’s own structured clinical management team. Visit our structured clinical management webpage for more information.

Our dialectical behaviour therapy (DBT) service is available across the entire Pennine Care area. If you or someone you know needs help, you can be referred to our programme through local mental health teams, including community mental health, secondary care psychology therapy, and structured clinical management teams in your borough.

Our evidence-based therapy is designed to support those dealing with behaviors such as repeated suicide attempts, self-harm, high impulsivity, and intense, unstable relationships that might endanger yourself or others.

For health professionals, we offer consultation and supervision to support you in working with individuals facing these difficulties.

Visit our dialectical behaviour therapy page for more information.

This service covers the whole of Pennine Care.

The democratic therapeutic community is a one-day-a-week group therapy approach. We offer a structured environment where you will come together with other people with a range of complex psychological conditions, to interact and take part in therapy.

It is designed to help if you have long-standing emotional problems and a history of self-harming, by teaching you skills needed to interact socially with others. As part of this you will develop an understanding of yourself. 

As well as taking part in group therapy, you would be expected to do other activities designed to improve your skills and self-confidence through peer interactions, communal experiences and shared group responsibility. This encourages a sense of belonging, personal empowerment and self-agency.

Visit our democratic therapeutic community webpage for more information.

This service covers the whole of Pennine Care.

Mentalizing is something we do with our minds to work out what we or others are feeling, thinking, or believing, and how this affects our behaviour. We can mentalize about ourselves, others and our relationships.

Mentalizing is important because it helps us make sense of ourselves and other people. It helps us cope with painful feelings and thoughts. It reduces the risk of doing things impulsively which might be harmful. It helps us to have improved relationships.

Mentalization-based treatment may be helpful if you want to better understand your own and other peoples’ minds and what causes you to act and feel as you do.

It can help you to develop and maintain more satisfying relationships, and to find new ways of understanding and coping with your emotions so that you feel more resilient.

Treatment involves a combination of individual and group sessions. Visit our mentalization-based treatment page for more information.

We are also working on developing services especially for people aged 65 and over with complex emotional and relational needs, in older person's psychological services. These are still in the early stages of development.

Visit our older person's mental health services page to see other services that are available.