Training NHS staff to work with people with trauma induced emotional regulation and interpersonal relational difficulties (TIERI)/borderline personality disorder
| DOI | https://doi.org/10.1108/JMHTEP-10-2019-0054 |
| Date | 03 February 2020 |
| Published date | 03 February 2020 |
| Pages | 45-58 |
| Author | Jurai Darongkamas,David Dobel-Ober,Beth Moody,Rachel Wakelin,Somia Saddique |
| Subject Matter | Health & social care,Mental health,Mental health education |
Training NHS staff to work with people
with trauma induced emotional regulation
and interpersonal relational difficulties
(TIERI)/borderline personality disorder
Jurai Darongkamas, David Dobel-Ober, Beth Moody, Rachel Wakelin and Somia Saddique
Abstract
Purpose –Improvement is sorely needed to the National Health Service (NHS) care for people with
trauma induced emotionalregulation and interpersonal relationaldifficulties (TIERI), currently labelledas
a variant of personality disorder [PD; borderline personalty disorder/emotionally unstable personality
disorder(BPD/EUPD)]. This study aims to improve staff training.
Design/methodology/approach –A mixed-methods evaluation demonstrated the benefits of offering
495 staffthree-day trainings with a clinician-designed,unique training package.
Findings –Statistically significant improvements were reported in both staff confidence and
optimism when dealing with people with a diagnosis of PD (PWDPD) and scores on the Helping
Alliance questionnaire. No statistically significant changes in social attitude resulted. Qualitative
data shows negative descriptions generated by staff decreased post-training with an increase in
positive and neutral descriptions. The responses generated six different the mes: resources, client
demand, medical model, emotional, human and positive rewards. Differing proportionswere found
pre and post-training.
Research limitations/implications –This was a clinical-world evaluation, not a formal research
project. Different pairs/combinations of experienced clinicians (predominantly clinical
psychologists) acted as trainers. Some minor variation occurred within the training package used
and presentation.
Practical implications –Given the expense of staff time and resources, this evaluation shows the
resultantpositive changes achieved. TIERI staffabout the difficulties experiencedby PWDPD and how to
negotiate the relational dynamic is essential. Training helps improve staff perception of the people
involved, improves staff confidence and promotes better therapeutic alliances (key to providing the
relationaland trauma work needed). Ongoing supervisionis likely needed post-training.
Originality/value –Positivechanges resulted from a mixed-methodsevaluation of three-day trainingsby
using a speciallydesigned training package.
Keywords Staff training, Personality Disorder, Staff attitude, Trauma, Relational difficulties,
Emotional regulation, TIERI
Paper type Case study
1. Introduction
Many consider the diagnosis of “personality disorder” (PD) contentious; a stigmatising label
(Newton-Howes et al., 2008;Bodner et al.,2015) with people with a diagnosis of personalty
disorder (PWDPD) viewed as having a “disordered” personality, “difficult to care for”, and
even “dangerous”. This stigma and the resulting negative attitudes held by many clinicians
can directly affect the treatment outcomes; nearly half (47 per cent) of 706 mental health
(MH) clinicians would prefer to avoid workingwith this client group (Black et al., 2011).
Jurai Darongkamas is
based at the Clinical
Psychology Service,
Birmingham, UK.
David Dobel-Ober is based
at the Research and
Innovation Department,
Midlands Partnership NHS
Foundation Trust, Stafford,
UK. Beth Moody is based at
the Research and
Innovation Department,
Midlands Partnership NHS
Foundation Trust, Stafford,
UK. Rachel Wakelin is
Department of Clinical
Health Psychology Queen
Elizabeth Hospital,
Birmingham, UK.
Somia Saddique is based
at Aston University,
Birmingham, UK.
Received 12 October 2019
Revised 12 December 2019
Accepted 12 December 2019
DOI10.1108/JMHTEP-10-2019-0054 VOL. 15 NO.2 2020,pp.45-58, ©Emerald Publishing Limited, ISSN 1755-6228 jTHE JOURNAL OF MENTAL HEALT H TRAINING, EDUCATION AND PRACTICE jPAGE 45
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