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  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    Dont Forget about the Carers!Supporting Carers of People with a diagnosis of Personality Disorder

    Alice Holland, Carer Consultant

    Dr Ruth Sutherland, Principal Clinical Psychologist

    Leeds Personality Disorder Managed Clinical Network

    BIGSPD - March 2018

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    The Carer Experience

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    The Group Programme

    Session Themes

    1What is Personality Disorder?

    Stay Well (WRAP)

    2 How does Personality Disorder develop?

    3Schema, Coping Responses & Personality

    Disorder

    4Staying Well

    Making Sense of Self Harm

    5 Treatment Principles and Options

    6Managing Day to Day

    Staying Well

  • social isolation/ alienation

    defectiveness/ shame

    emotional deprivation

    mistrust/

    abuse

    abandonment/ instability

    Early maladaptive

    schema

    I cannot understand how

    anyone could love me

    Care givers/other adults might have ridiculed/criticised

    or blamed

    Care givers/other adults might have been cold,

    not giving affection

    people are not going to be there for me

    Care givers/other adults might have criticised / humiliated / abused

    people will take advantage of me

    people will always leave me

    Care givers/other adults might have left them or not been available

    The family might have been very

    different to others

    Im totally different to

    everyone around me

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    What the group was really like

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    Outcomes: Demographics (Groups 1-3)Total number of attendees over three groups: 19

    Drop out: 4

    0

    2

    4

    6

    8

    Cared-for person

    0

    5

    10

    15

    male female

    Gender

    0

    1

    2

    3

    4

    5

    6

    7

    8

    18-25 26-35 46-55 56-65 Over 65

    Age

    0

    5

    10

    15

    20

    White British Other

    Ethnicity

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    Outcome Measures (Groups 1-3)

    Personality Disorder: Knowledge and Skills Questionnaire

    (Bolton et al, 2010, adapted).

    T-test indicated a statistically significant change in scores

    (p=0.000000620)

    Short Warwick-Edinburgh Mental Well-being Scale

    T-test indicates no significant change in scores (p=0.268)

    Carer Satisfaction Questionnaire

    (Larsen et al., 1979, adapted)

    All responses fell into the very satisfied or mostly satisfied

    categories, except one response in the somewhat satisfied.

    No responses fell into the not satisfied category

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    SatisfactionWhat was helpful about the group?

    Opportunity to share experiences with other carers

    Feeling validated and hopeful

    Opportunity to learn about personality disorder

    Facilitators perceived as interested, helpful, professional,

    knowledgeable and experienced

    What could be better?

    More time to discuss topics and issues in-depth

    More opportunities for discussions in pairs/small groups

    The group should lead on to further ongoing support

    A need for balance between specific topics and more open

    space for support

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    Service Outcomes

    Psychoeducational group to run 2-3 times per year

    New bimonthly Peer support group in partnership with

    Carers Leeds

    Recruitment of a Carer Consultant to co-facilitate groups

    Development of a training package to support other

    services in supporting carers

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    Becoming a Co-facilitator

  • The Great Parts of Personality Disorder

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    ReferencesNICE (2009). Borderline Personality Disorder: Recognition and

    Management https://www.nice.org.uk/guidance/cg78/evidence

    Copeland, M.E. (1997). Wellness Recovery Action Plans. Peach Press, San

    Francisco, CA

    NHS Health Scotland, University of Warwick and University of Edinburgh

    (2008). Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS)

    http://www2.warwick.ac.uk/fac/med/research/platform/wemwbs/swemwbs_7

    _item.pdf

    Bolton, W., Feigenbaum, J., Jones, A., and Woodward, C. (2010).

    Development of the PDKASQ (Personality Disorder Knowledge, Attitudes

    and Skills Questionnaire)

    Larsen, D.L., Attkisson, C.C., Hargreaves, W.A., and Nguyen, T.D. (1979).

    Assessment of client/patient satisfaction: Development of a general scale.

    Evaluation and Program Planning, Vol. 2, pp197-207

    https://www.nice.org.uk/guidance/cg78/evidencehttp://www2.warwick.ac.uk/fac/med/research/platform/wemwbs/swemwbs_7_item.pdf

  • integrity | simplicity | caring www.leedsandyorkpft.nhs.ukintegrity | simplicity | caring www.leedsandyorkpft.nhs.uk

    For more information:

    PDcarers.lypft@nhs.net

    0113 8557951

    mailto:PDcarers.lypft@nhs.net