Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

BACKGROUND
For many years, because of
the controversy about the
diagnosis, some practitioners
have chosen not to share the
diagnosis with the service user.
Although there are challenges
to giving people this diagnosis,
if someone has been formally
diagnosed with personality
disorder, we recommend
sharing this information with
the individual themselves.
Many of the benefits of
having a diagnosis are only
available if it is shared with
the service user, such as
feeling less alone, being able
to find out more about the
difficulties and how others
have survived similar
experiences. One of the
key elements of working
effectively with people with
these difficulties is an
emphasis on the relationship
between staff and service
user. Service users cannot
make informed choices or
work in partnership with
staff to develop support
plans/formulations and so
on, if their diagnosis is hidden
from them.
It’s not the label that matters but what
happens afterwards.
‘‘They have given me the label Borderline Personality
Disorder. I don’t seem to be getting a referral to any
kind of service, or any help that I need. After years of
desperation, of suicide attempts, hospital admissions
and a body pumped full of medication they have
given me this label and walked away.”
“My brother is now in his 50’s and has suffered all his
adult life with OCD and PD. Good PD services are not
available in the area in which he lives so he has had
to ‘make do’ with a weekly general mental health
group which keeps him ‘well enough to work’ but
does not address underlying issues. I am sure that,
should good services have been available, he would
now be living a much more worthwhile and fulfilled
life, rather than just existing from day to day.”
There is now a view that if the label has some advantages, it can
be tolerated, as long as the person is informed of the diagnosis
in a way that feels supportive and informative. When giving the
diagnosis or discussing it with a service user, it is helpful to refer
to the controversy surrounding it, and the discomfort many
people feel in using it. Explaining that it is actually shorthand
for ‘complex and long term emotional and psychological
difficulties’ and does not imply any judgment or blame, is likely
to be reassuring, especially if accompanied by an offer of
appropriate treatment and support.
27