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

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THE TERM ‘PERSONALITY DISORDER’ HAS BEEN CRITICISED FOR THE FOLLOWING: • There is no clear cut-off between someone who has an unusual or troublesome personality, and someone with a ‘disorder’. • Individuals labelled as having a ‘personality disorder’ might feel that this marks them out in a way that is stigmatising or unhelpful. to harm herself. Kelly finds it very difficult to be alone; when alone she feels empty and frighteningly unsure of who she is. When feeling desperate she sometimes cuts herself, and she took two overdoses in the last 2 years. Susan has been suffering from anxiety and panic for over 20 years. She relies heavily on her teenage children, expecting them to accompany her whenever she leaves the house, and calling them on their mobile phones if she panics when alone. She also often calls the emergency services, imagining that she is having a heart attack when she has anxiety symptoms. She has been repeatedly referred to mental health, IAPT and psychology services for treatment of her anxiety and agoraphobia, but has difficulty getting to appointments and has never stuck with any treatment programme. Her older daughter has recently been missing a lot of school because she has been staying at home to care for her mother. Do you recognize anyone with similar, longstanding difficulties amongst the people that you work with? If so, reading this guide may help you in your work. When working with people who have personality problems, we do not want them to feel labelled, put down, or squeezed into diagnostic boxes. They are fellow human beings, many of whom have suffered greatly as they were growing up, and now struggle in adult life. We want to help people on the road to recovery by working alongside them in a respectful way, working together, helping to build their sense of trust and confidence. The language that we use is therefore very important. Service users sometimes say that they do not like the abbreviation ‘PD’, or to be seen as nothing but a disorder. A number of different phrases have been used to describe these difficulties or people with these kinds of difficulties, including: • ‘Complex and severe psychological difficulties’. • ‘Complex needs’ (this is sometimes also used to refer to people with severe mental illness). • ‘People diagnosable with personality disorder’. • ‘People who identify with the problems associated with the diagnosis of personality disorder’. In this guide we are going to stick to using the phrases ‘personality disorder’ or ‘personality difficulties’ though we will describe some of the problems with these terms. We all have personalities, and we all have aspects of our personalities that are troublesome at times. People with personality disorder are not fundamentally different from anyone else, but might, at times, need extra help. 6
WORKING TOGETHER Professionals have come to recognise that working alongside service users with diagnosable personality disorder to plan, design and deliver services has led to better services and a better experience for everyone. Service users’ views are taken seriously, service users have the opportunity to hold valued roles and influence, and professionals get a much better idea of what is really needed and what really helps. This guide has been produced through service users (‘experts by experience’) working with professionals (‘experts by training’) in a collaborative and equal way. 7
Page 1 and 2: Working effectively to support peop
Page 3 and 4: Contents Foreword .................
Page 5 and 6: Executive summary It’s not person
Page 7: INTRODUCTION THE PURPOSE OF THIS GU
Page 11 and 12: BACKGROUND Each person’s personal
Page 13 and 14: BACKGROUND • People with personal
Page 15 and 16: BACKGROUND taken overdoses is stock
Page 17 and 18: BACKGROUND How do we describe and u
Page 19 and 20: BACKGROUND 1) Openness (seeking out
Page 21 and 22: BACKGROUND “Music has got me thro
Page 23 and 24: LEARNING POINTS FROM CHAPTER 1 —
Page 25 and 26: BACKGROUND There is no underlying
Page 27 and 28: BACKGROUND The notion of treatabili
Page 29 and 30: BACKGROUND For many years, because
Page 31 and 32: Learning points from Chapter 2 —
Page 33 and 34: BACKGROUND Most professionals agree
Page 35 and 36: BACKGROUND soothing, responsive car
Page 37 and 38: BACKGROUND THE THEORY OF MENTALIZAT
Page 41 and 42: PRACTICAL GUIDANCE RECEIVING GOOD C
Page 43 and 44: PRACTICAL GUIDANCE What might get i
Page 45 and 46: PRACTICAL GUIDANCE THERE ARE MANY R
Page 47 and 48: PRACTICAL GUIDANCE HELPFUL THINGS T
Page 51 and 52: PRACTICAL GUIDANCE Here are some ex
Page 53 and 54: PRACTICAL GUIDANCE Some teams will
Page 55 and 56: PRACTICAL GUIDANCE Specific psychol
Page 57 and 58: PRACTICAL GUIDANCE borderline and a
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Learning points from Chapter 5 —
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PRACTICAL GUIDANCE There are many d
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PRACTICAL GUIDANCE It is extremely
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PRACTICAL GUIDANCE 6) ISSUES OF POW
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Page 69 and 70:
PRACTICAL GUIDANCE We all know that
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PRACTICAL GUIDANCE Common defences
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PRACTICAL GUIDANCE It is possible t
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PRACTICAL GUIDANCE ORGANISATIONAL V
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therapist and client is a collabora
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Appendix 2: References and resource
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SELF HARM: National Self Harm netwo
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Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

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