Raising awareness of Borderline Personality Disorder

To mark Borderline Personality Disorder (BPD) Awareness Month, colleagues from our complex needs service tell us more about their roles and the support we provide for those with complex emotional needs.

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Consultant Psychologist Dr Rowena Jopling tells us more about her role and the support we provide individuals experiencing BPD

Q. Could you share a bit about your role within the trust and how it intersects with the awareness and support initiatives during Borderline Personality Disorder Month?  

As the clinical lead for individuals with complex needs within our trust, my role focuses on advancing our understanding and support for those diagnosed with borderline personality disorder (BPD), also known as Unstable Personality Disorder. During BPD Awareness Month, we aim to highlight innovative initiatives we are implementing to better support individuals with complex emotional needs and their careers. This includes showcasing new projects that are designed to improve the quality of care and support available.

Q. In your experience, how does our Trust contribute to raising awareness and improving services for borderline personality disorder?

Dr. Jopling: Our trust adopts a person-centred approach, referring to BPD as "complex emotional needs" to honour the preferences of those affected as we recognise that not all people are comfortable with the diagnostic label.

We are involved in several exciting and innovative projects, supported by top organisations like the South London Partnership. These projects aim to enhance service delivery by improving inpatient care, facilitating smoother discharges, and offering better therapeutic options. We work closely with carers and continuously seek ways to strengthen our support network.

Image of clinician who is the focus of this Q&AQ. How does your work directly impact individuals affected by borderline personality disorder, particularly during Borderline Personality Disorder Month?

As the Trust lead, I focus on fostering a community of expert practice. We hold bi-monthly meetings with our Clinical Reference Group to oversee and refine our care pathways, ensuring they meet the needs of our planning groups. I co-chair this with Daniella Lewis who has lived experience. Our initiatives are based on thorough analysis and audits of our services, allowing us to develop and implement best practices. This month we are highlighting these new projects and the tangible improvements they bring to individuals' lives.

Q. Can you elaborate on any specific projects or initiatives your team is undertaking during Borderline Personality Disorder Month?

One of our key projects involves the ASCENT team which we are working in partnership with the South London Partnership, which focuses on identifying individuals on inpatient wards who would benefit from additional support, such as occupational therapy and psychological therapies. We strive to provide equitable access to our therapies across all boroughs.

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Clinical Psychologist Dr Rachel Ashwick tells us more about her role and the support we provide individuals experiencing BPD

 Q. Could you tell us a bit about your role within the Trust?

Operating within the Integrated Recovery Hubs (IRHs), I spearhead the setup of the Dialectical Behaviour Therapy (DBT) skills training groups in Wandsworth. We were very excited to have the first ever DBT skills group in Wandsworth set up, which started on 17th  April 2024. These groups involve conducting two to three sessions of pre-treatment, followed by six months of weekly skills groups, supplemented by phone coaching for additional support and a one-to-one follow-up review at the end of treatment.

I collaborate closely with a consultation team of DBT practitioners and the trust DBT lead as well as the IRH psychology team to ensure comprehensive care. I conduct psychology triage assessments upon referral into psychology to determine the best treatment pathway for clients and provide consultations to the multidisciplinary team 
on complex cases. Within my role as a psychologist, I supervise several staff delivering interventions, and offer teaching to the team as well as trauma-informed team formulations which are integral aspects of my role.

Image of clinician who is the focus of this Q&AQ. What are some of the challenges you have faced?

Integration of care across multiple professionals poses a significant challenge. Balancing client needs across different professions and services with clinical guidance is another common hurdle as we want to ensure connectivity and continuity of care. It's crucial to navigate these challenges while maintaining a client-centred approach and adhering to evidence-based practices.

Embracing models like the biosocial model and power-threat-meaning framework allows us to see the person behind the diagnosis and I try to actively promote these approaches in our team. The biosocial model helps us understand how individuals, through no fault of their own, may have an inherent vulnerability to experiencing intense emotions and when accompanied by environments which invalidate their emotions, they understandably develop difficulties managing distress.

The power-threat-meaning framework is also helpful for understanding how an individual has learnt to survive power imbalances throughout their lives by understanding the way they have learnt to think and respond as a means of survival and coping. Understanding individuals in the context of their past experiences and promoting these approaches requires ongoing teamwork and collaboration across services to ensure clients receive the best possible care.

Q. What are some of the initiatives you and your team are taking to support individuals with BPD?

Looking ahead, our vision includes running multiple DBT groups simultaneously in a variety of locations as well as online to improve access for clients. The trust also hopes in the future to establish a full DBT program which includes one-to-one therapy in addition to the group in Wandsworth. By expanding our DBT offerings and providing tailored support, we aim to meet the diverse needs of individuals with BPD more effectively. Additionally, ongoing training and collaboration with other professionals ensure that our interventions remain evidence-based and responsive to the evolving needs of our service users.

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Image of Daniella and Kelly Meet lived experience members Daniella and Kelly

Daniella and Kelly bring invaluable insights and hope through their roles in the Trust. Their lived experiences and dedicated work with the ASCENT team demonstrate the positive impact of peer support and the importance of reducing stigma around Borderline Personality Disorder (BPD). Through their efforts, they inspire others to see the possibilities of recovery and a fulfilling life beyond the diagnosis.

Insights from Daniella:

I have been working with the Trust for three years, specifically with the BPD/complex needs team. Diagnosed with BPD in 2012, I received tremendous support from the Trust, which has been pivotal in my recovery journey. My role includes KUFF training, where I share knowledge and frameworks with professionals to help them better support clients diagnosed with BPD.

Last year, I qualified and now co-chair the clinical reference group on complex emotional needs alongside Dr. Rowena Jopling. I am also heavily involved with ASCENT, a new service co-produced by individuals with lived experience, including myself. The Ascent team focuses on identifying individuals on inpatient wards who would benefit from additional support, such as occupational therapy and psychological therapies. I have been part of ASCENT from its inception, including interview selection, and I feel that my lived experience has been genuinely valued and appreciated.

Insights from Kelly:

I work for the ASCENT team, which provides adaptive support for complex emotional needs. As a peer support worker, I focus on offering long-term care tailored to individuals with BPD. This includes intense therapy sessions, involving talking therapies with psychologists and occupational therapists. My role is to provide support and encouragement, helping patients navigate their therapy and recovery processes.

Even though BPD is a severe mental health issue, there is light at the end of the tunnel. You can live a healthy, happy life despite the diagnosis. Patients often find inspiration in my journey and my ability to live well regardless of having BPD. A common misconception is that BPD is incurable. There's no magic pill for BPD, which can lead to frustration and uncertainty among staff on how to provide effective care. However, with the right support and treatment, individuals with BPD can lead fulfilling lives. My diagnosis has become my strength.

 

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