Training graduate primary care mental health workers to work with people with a diagnosis of personality disorder

Abstract

It is recognised that training is required for staff working with people with a diagnosis of personality disorder, as it poses challenges requiring particular skills and abilities (National Institute for Mental Health in England, 2003a). The proposal to train graduate primary care mental health workers (GPCMHWs) to work with the client group met with some scepticism by senior clinicians. However, the experience of providing training and supervision to the graduate primary care mental health workers to work with clients with personality disorder in Camden and Islington has proved positive. Several characteristics of the GPCMHWs identified in the training literature might contribute to this positive experience. Those factors include cognitive ability, motivation to learn, age, and attitudes. Initial findings from the evaluation of the training shows that graduate workers respond positively to the training, showing improvements in self-rated knowledge and skills relating to working with the client group, and an eagerness to learn more. The relevance of this to the personality disorder capabilities framework are described.

Impact on staff attitudes of brief personality disorder training for acute psychiatric wards

“…In particular, research has identified a need for training qualified mental health nurses working in acute services, with 89% of respondents requesting further acute care education post-registration (Jones and Lowe, 2003). Implementing targeted training can be an effective way to improve understanding, optimism and confidence, as well as improving staff attitudes towards service users with a diagnosis of “personality disorder” (Clarke et al , 2015; Darongkamas et al , 2020; Ebrahim et al , 2016; Lamph et al , 2014; Woodward et al , 2009). Training that is targeted at structuring the environments of service users diagnosed with “personality disorder” has been found to help staff develop a skillset for working effectively with service users who have difficulties in recognising and regulating emotions, through reflective practice, peer support and decreasing their levels of work-related stress (Burke et al , 2019).…”

Preliminary evaluation of personality disorder awareness workshops for prison staff

“…Certain factors need taking into consideration regarding the positive finding about the ''security versus vulnerability'' sub-scale. Potentially the workshop may have generated most impact upon those already receptive to developing their understanding of personality disordera comment noted within the Woodward et al (2009) study. The extent to which the PDA workshop can improve deeply entrenched negative attitudes remains untested.…”

“…Participant's recognition of relevant experience with personality-disordered offenders will remain a methodological weakness which may potentially have confounded the findings. Using a single outcome measure is not ideal, although two of the studies cited within the introduction based their findings upon single measures (Miller and Davenport, 1996;Woodward et al, 2009). The post-session evaluation sheets do, however, provide some additional support for the Bowers, L., Carr-Walker, P., Allan, T., Callaghan, P., Nijman, H. and Paton, J.…”

“…The majority of studies cited within this literature review do not overtly state any underlying models used to either explain personality disorder or to produce trainee's attitude/behavioural change, although some have been more specific. Woodward et al (2009) evaluated a series of four half-day awareness workshops which were underpinned by a biosocial model of borderline personality disorder. Miller and Davenport (1996) created a 90-minute self-instructional borderline personality disorder training programme covering topics such as aetiology, manifesting behaviour, staff reactions and treatment.…”

“…A small number of published studies used tests and questionnaires to measure the effectiveness of awareness training focused on personality disordered and sexual offenders. Woodward et al (2009) included selected APDQ questions in their pre-and post-training measure, observing significantly increased understanding of personality disorder. Miller and Davenport (1996) used Reece's Questionnaire on Borderline Personality Disorder (BPDQ, unpublished study, 1988) to evaluate nurse's knowledge of, and attitudes and behavioural intentions toward patients with borderline personality disorder.…”