Beyond the walls of Camden & Islington personality disorder service: a qualitative study of clinical consultation to external services

2021 ◽  
pp. 1-22
Author(s):  
Andrew White ◽  
Abi Herbert ◽  
Pierise Marshall
PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0206039 ◽  
Author(s):  
Yeow May Tan ◽  
Christopher W. Lee ◽  
Lynn E. Averbeck ◽  
Odette Brand-de Wilde ◽  
Joan Farrell ◽  
...  

Author(s):  
Gary Lamph ◽  
John Baker ◽  
Tommy Dickinson ◽  
Karina Lovell

Abstract Background: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care ‘Improving Access to Psychological Therapies’ (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. Aims: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the ‘Standardised Assessment of Personality – Abbreviated Scale’ (SAPAS) in receipt of primary care-based IAPT treatment. Method: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. Results: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. Conclusions: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.


2014 ◽  
Vol 38 (3) ◽  
pp. 116-121 ◽  
Author(s):  
Lawrence Martean ◽  
Chris Evans

Aims and methodTo explore experiences of psychiatrists considering medication for patients with personality disorder by analysis of transcribed, semi-structured interviews with consultants.ResultsThemes show important relational processes in which not prescribing is expected to be experienced as uncaring rejection, and psychiatrists felt helpless and inadequate as doctors when unable to relieve symptoms by prescribing. Discontinuity in doctor–patient relationships compounds these problems.Clinical implicationsProblems arise from: (a) the psychopathology creating powerful relational effects in consultation; (b) the lack of effective treatments, both actual and secondary to under-resourcing and neglect of non-pharmaceutical interventions; and (c) the professionally constructed role of psychiatrists prioritising healing and cure through provision of technological interventions for specific diagnoses. There is a need for more treatments and services for patients with personality disorder; more support and training for psychiatrists in the relational complexities of prescribing; and a rethink of the trend for psychiatrists to be seen primarily as prescribers.


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