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Don’t 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
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The Carer Experience
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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
“I’m totally different to
everyone around me”
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What the group was really like…
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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
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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
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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
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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
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Becoming a Co-facilitator
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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
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For more information:
0113 8557951