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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


The Carer Experience


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”


What the group was really like…


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


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


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


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


Becoming a Co-facilitator

The Great Parts of Personality Disorder


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/evidence

http://www2.warwick.ac.uk/fac/med/research/platform/wemwbs/swemwbs_7_item.pdf


For more information:

[email protected]

0113 8557951

mailto:[email protected]

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