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Managing the 'Unmanageable'
Training staff in the use of dialectical behaviour therapy for borderline personality disorder
Mike Hazelton
Professor of Mental Health Nursing, School of Nursing and Midwifery, University of Newcastle, Callaghan NSW
Rachel Rossiter
Clinical Nurse Consultant, Psychotherapy, Centre for Psychotherapy, Hunter New England Mental Health, Newcastle NSW
Julie Milner
Clinical Coordinator, Hunter Valley Mental Health Service, Melbee House, Maitland Hospital, Maitland NSW
Abstract
Ninety-four staff from a regionally based mental health service and associated health and human services completed a two-day workshop introducing dialectical behaviour therapy, with a smaller number also undertaking advanced training. Survey and focus group data were collected on participants' demographics, attitudes, knowledge and experience of working with persons with this disorder, prior to and at one-month and six-months following completion of the introductory workshops.
Quantitative and qualitative findings indicated that involvement in the training program was a positive experience for the majority of participants, with knowledge regarding detection and treatment and staff attitudes toward consumers being improved following exposure to the principles and practice of dialectial behaviour therapy. Discourse analysis of the focus group interview data pre- and post-training indicated a significant shift in the meanings staff associate with borderline personality disorder, with a pervasive therapeutic pessimism being displaced by more optimistic understandings and outlooks. Improved therapeutic outlook is likely to have positive implications for staff engagement with service users with borderline personality disorder.
While this article provides a brief overview of the findings of the survey, the main purpose is to report the findings of the focus group interviews.
Keywords
borderline personality disorder, dialectical behaviour therapy, clinical practice development, mental health services, therapeutic optimism, rural mental health
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