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Humerah Miah is optimistic that a therapeutic community programme can help to treat self-harming behaviour.

When I kept going in and out of psychiatric hospitals as if caught in a revolving door, it soon became clear that my self-harming behaviour could not be treated on an acute ward or be adequately supported in the community.

Therefore in the process of considering other options, which included long-term residential care, the idea of going to a therapeutic community was mooted. My initial reaction was "No Way". I did not want to make a long-term commitment. However, I was persuaded to go for an assessment and subsequently offered a place on the Acorn Programme, at a Quaker hospital in York called the Retreat.

The average length of stay is eight months. The programme specialises in working with people with self-defeating behaviour and adopts as its main approach dialectical behaviour therapy (DBT). In a nutshell, this therapy is a broad-based cognitive behavioural treatment programme focusing on developing skills such as "mindfulness", interpersonal effectiveness, emotional regulation and distress tolerance.

The programme's emphasis on taking responsibility for yourself can sometimes be difficult when the urge to self-harm is strong. There is a hectic weekly schedule with group work, including psychotherapy, drama therapy and DBT skills workshops.

Each day is started with a community meeting, where residents and staff talk about how they are feeling or any other issues that are on their minds. The same process happens at the end of the day. These meetings can be very supportive and challenging, as everyone is expected to participate, and members of the group can raise questions, make observations or comment on things being said.

I self-harmed one day and, as I am accountable to the group, I had to say what I had done. I was questioned on why and how I had self-harmed. I also got a lot of support for thinking of ways of avoiding self-harm and dealing with my urges in a more effective way. Everyone is encouraged to deal with their distress with the support of the group, rather than isolating themselves or engaging in self-defeating behaviour.

Although the emphasis is on group activities, there is time to have individual sessions with the consultants, nurses or the dietician. Everyone has to keep a diary documenting their self-defeating behaviour and the skills they have used to overcome them. In addition to the diaries, if someone engages in self-defeating behaviour they have to do a chain analysis examining everything from the events leading up to it to the impact on others afterwards.

For me it is early days on the programme, but I am quietly optimistic that the approach adopted in this therapeutic community will be worthwhile. It is not an easy place to be; after just a fortnight I am finding it more challenging than any of the other mental health services I have used. However, I am committed to stopping my self-harm and building a life worth living. Hopefully, from little acorns great things will grow.

Humerah Miah is a mental health service user.