Discover how AMBIT transforms treatment at Ellenhorn in our interview with Director Shelly Simpson. Learn about the benefits for both teams and clients.
What is AMBIT?
AMBIT is a system of care designed to support teams who care for particularly complex clients who struggle with the belief that “help” can be helpful. It stands for “adaptive mentalization-based integrative treatment,” meaning that it is a flexible approach that integrates all parts of care with mentalization that is at the heart of all interventions.
What types of clients benefit from an AMBIT approach?
I think it is actually the client’s team that benefits from the approach, and the client who benefits from the mentalization-based care. People with a wide range of complexities, whether long (and unsuccessful) treatment histories, difficulties with sense of self and self-regulation, attachment-related issues and/or complex trauma, have all been shown to benefit from mentalization-based care and intervention.
So, how does AMBIT help teams then?
When working with people who experience significant distress, AMBIT assumes that one’s ability to maintain mentalizing capacity is greatly impacted. However, this breakdown of mentalization is not a client’s issue to solve, but a worker, colleague and team issue. AMBIT helps teams apply mentalization to direct care and, in turn, support one another, the network of outside providers/supporters, and a culture of learning and adaptation. The act of doing so reduces anxiety, provides clarity and makes space for more creative, person-centered interventions.
Is AMBIT widely practiced?
AMBIT is practiced all over the world, but it is especially popular in the United Kingdom due to the fact that the Anna Freud Centre, which is based in London, is the hub for AMBIT creation, research, education and training. Our Ellenhorn staff was trained in AMBIT by experts from Anna Freud more than six years ago and has been utilizing it ever since. In fact, with their help, Ellenhorn is now the first accredited AMBIT training organization in the United States. It has taken a lot of training, practice and hard work to get us to this point, and we are incredibly excited.
What do you find most exciting about being an accredited AMBIT training organization?
I have been working on and leading teams who treat complex clients for the past 10 years, but it wasn’t until I was trained in AMBIT that I was truly able to use my training in (and love of) mentalization to help our whole system of workers, clients and their network. AMBIT is dimensional, respectful of clients’ autonomy and considerate of clinician anxiety. AMBIT offers a way to think about care differently, and also offers tools to provide care differently. AMBIT values flexibility and continuous learning, and, by being an accredited training organization, we get to be a part of all of that!
How do you think AMBIT could help other organizations?
The way I have seen AMBIT help Ellenhorn has been pretty cool, so I’m excited to share the knowledge we’ve gained about it with other organizations. Ellenhorn has long been known as a program that works with clients who struggle with extreme states of mood and mind. We were originally trained in open dialogue, which is a model we still use to find help for our clients who experience psychosis.
Over time, we noticed that some of our Ellenhorn teams and clients were struggling with the approach, particularly those clients who have difficult experiences with sense of self and what is often coined as “cluster B traits.” These clients needed more containment and holding than open dialogue purposely provided. The staff also felt uncontained and “unheld,” which caused a lot of contagious anxiety that impacted our ability to meet people where they were at and engage in creative problem-solving. When we found AMBIT, we hoped that it would be a curative and, thankfully, it was. I think most organizations go through phases like ours did, and I think AMBIT is a great addition to clinical care. AMBIT training focuses not only on mentalization-based interventions, but team and leadership interventions. It is a top-down training that requires participation from all stakeholders. It is meant to be culture-shifting.
What types of organizations might benefit from being AMBIT trained?
Any organization that works on teams, whether multidisciplinary or interdisciplinary, and wants a new structure to support the mentalizing capacity of their workers and clients. If an organization is new to the concept of mentalizing, no worries—that is part of the training as well! AMBIT helps clinicians contain their anxiety when working with high-risk clients and helps teams learn how to best support one another in moments of high anxiety. In a way, AMBIT holds the team, so the team can hold the client; I find that so special.
Where can someone get more information and find out about getting trained in AMBIT?
Me! If you can’t tell, I am a total nerd for AMBIT and would love to talk to anyone interested in learning more. Feel free to reach out to me via email, at ssimpson@ellenhorn.com.
