making sense of the chaos developing borderline personality disorder services in clackmannanshire

Making Sense of The Chaos

Developing Borderline Personality Disorder Services in Clackmannanshire

Why we’re here…

Who we are,

where we are

and what we’re up to

FORTH VALLEYINPATIENT/OUTPATIENT SPLIT MODEL

INPATIENT WARDSINTENSIVE HOME TREATMENT

TRAUMA CLINIC

DYNAMIC PSYCHOTHERAPY

SOUTH SECTOR

NORTH SECTOR

CLACKMANNANSHIRE

PSYCHIATRY SERVICES

COMUNNITY MENTAL HEALTH TEAM

DAY UNIT

OUT PATIENT

PSYCHOLOGY

GPMENTAL HEALTH

SERVICES

PHOENIX CENTRE

COUNSELLING

COMMUNITY ACCESS TEAM

CBT

SUPPORTED EMPLOYMENT TEAM

DEVON HOUSE

GPPRIMARY CARE PSYCHOLOGY

ON CALL PSYCHIATRIST

MENTAL HEALTH SERVICES

PSYCHIATRY SERVICES

IHTT LIAISON

REHABILITATION TEAMTRAUMA CLINIC

INPATIENT CARE: W1, W2, W3

DYNAMIC PSYCHOTHERAPY

SERVICES

Service Development

Collaboration between

psychologists

Solution-focused

therapy (SFT) group

BPD Working Party

Training

Model of Care

Model of Care

Shared, consistent care

Trust and understanding

Empowerment and recovery

Service DevelopmentCollaboration

between psychologists

Solution-focused therapy

(SFT) group

BPD Working Party

Training

Model of Care

Audit

Complex Case

Discussion

Resource Pack

Mentalisation Training

Groups

Groups

A positive, collegial, solution-

focused stance

Looking for previous solutions

Present- and future-focus

Use of questions

Looking for exceptions

Use of compliments

Solution-focused goals

Guided by Solution-focused principles

Main interventions

Group Development

Original pilot group Clackmannanshire

Second Clackmannanshire group and further

SFT training

Third group in Clackmannanshire

Pilot group within CMHT

in Falkirk area

Further evaluation of groups

Ongoing Work

Groups

Database and referral systemDissemination of audit findingsCompletion of Resource Pack

Outcomes

GPPRIMARY

CARE PSYCHOLOGY

ON CALL PSYCHIATRI

ST

MENTAL HEALTH

SERVICES

PSYCHIATRY SERVICES IHTT LIAISON REHABILITA

TION TEAM

TRAUMA CLINIC

INPATIENT CARE: W1,

W2, W3

DYNAMIC PSYCHOTHERAPY SERVICES

Outcomes (2)“My ideal model is similar to the existing model that is in Clacks – a team approach that involves the consultant, psychologist and keyworker…Work should be clear and consistent between the staff team and also with the patient. This approach feels safer for managing risk and clinical judgements because it helps you to feel more supported, more included in decisions, promotes equality amongst staff groups and it helps to provide a consistent and professional approach. Everyone is working in the same way and the patient is aware of this and they learn they need to work within these boundaries.”

Clinician’s perspectives

Outcomes (3)“A team approach - honesty in the relationship is valuable. Integrity is fundamental. I've been put back together in a way that is sustainable. I trust the team and know that putting someone together is the treatment.”

Service-users’

perspectives

“It is great to have three competent individuals working with me - a safety net. The four of us work together and conversations go on between all of us. I will take their advice. Sometimes someone lets the safety net go a bit slack but this can be a good learning exercise. I have faith that the safety net is always there.”