Treatment and Pathways of Care
'Much More Than a Label' presented at the Scottish Personality Disorder Network Conference on Thursday 4th June 2009 and also there was a workshop. Personality Disorder Tookit Workshop.
Resource List
Note: many links are to PDF and Word files.
Service User-Led Organisations Information:
Information About Personality Disorder:
Information for Carers:
Information for GPs:
General Letter:
Housing Letter:
Information for Staff:
- Advice for A&E Staff: http://www.nshn.co.uk/upload/A_E-inside(DPS)_.pdf and http://www.nshn.co.uk/upload/A_E-outside(DPS)_.pdf
- About Self-Harm
Support Materials for Service Users:
- Self Harm Checklist Part 1 and Part 2
- Treatment Refusal Part 1 and Part 2
- Crisis: What To Do When Life Gets Too Much
Myths About BPD
Misconceptions:
Positives of BPD:
- The Positives of BPD
- Positive and Negative BPD Characteristics are Two Sides of the Same Coin - (www.middle-path.org)
Treatment:
- Cognitive Behavioural Therapy for BPD
- Dialectical Behavioural Therapy
- Stop and Think Good Practice Guidelines - Nottingham Service Users
Self-Help:
A number of national projects are moving in the same direction and the Mental Health Delivery plan has described the importance of designing Integrated Care Pathways for a number of diagnostic groups with one of these being Borderline Personality Disorder.
The BPD Integrated care pathway will use the current best evidence gained from systematic reviews, as well as input from a multidisciplinary committee, to outline the optimal course of care for all clients.
The SPDN is contributing to this process as we have had a main floor presentation from Dr Ali El Ghorr, ICP Programme Resource Manager and workshops where attendees were actively able to feedback on the work to date of the group looking at treatment pathways for BPD. Linda Treliving is chairing the BPD ICP which again allows for continuity in developing of treatment and interventions for the service users.
Future developments
Further consultation and cooperation with QIS ICP group for Borderline personality Disorder will be available at each conference. This allows the BPD group to have a wide multi-disciplinary consultation during the development process that is invaluable in such a complex task.
For more information on ICPs visit the Integrated Care Pathways website.Following the presentation on "Mentalisation Based Treatment" by Professor Anthony Bateman there has been adequate interest from clinicians to receive training as trainers in this approach and establish a multi centre trial of MBT which could be compared to CBT or treatment as usual
If you have any ideas or feedback on this issue please get in touch with us.
Feedback
Feedback from a workshop held at the Scottish Personality Disorder Network yesterday (8th November 2007) was favourable regarding the new generic model.
Specific comments surrounded:
- psychological therapies - it in under assessment in generic they would also like a standard to be under Care Delivery (like medication). I agree with this as it would give a bit more impetus to psychological therapies and would perhaps help with being more explicit with the rationale regarding validated therapies/timescale recording for referral and delivery etc.
- in-patient admission. They were happy with the generic criteria in that the admission aims were clearly identified, so this may mean that we can drop the current condition specific standard as the way it currently reads does not make sense.
- to replace the condition specific standard on admissions could we add one such as....it should be recorded that there are structured approaches for the management of BPD such as the formation of formal groups, facilitated socialisation and 'formal' agreements between service user and care staff regarding treatments? This is what makes the management of BPD 'different' from other conditions.
Other than above, it went down much easier than previous workshops at the same network indicating to me that the ICP concept has been sold and accepted!
Regards,
Rosie
What's happening in Ayrshire and Arran?
"News from here is that the care of people with personality disorder has been included in our local strategic review of mental health services, where service and treatment models are being discussed. The overall proposals from this review will be presented to the NHS Board and then possibly parts of the plan will require independent scrutiny. The PD group is having a bit of a break at the moment, although we've had one meeting regarding ICP and will follow this up in the new year once the final standards have been published.
"We've been considering carefully how best we can involve people who have the diagnosis and are having discussions with several people who are keen to help in some way. We're also piloting the use of Tidal Model in several areas, one of which is an area for intensive continuing care within which there are a number of people with complex needs. Similarly in two of our acute wards we're introducing Tidal as a beginning to look at recovery focused practice. Early days, but we're hopeful that this will assist with people's (many with personality disorder) experience of inpatient care and beyond."
Lesley Brady, AAPCT