Women's Personality Disorder

Naseby is a specialist comprehensive dialectical behaviour (DBT) unit, specifically for the treatment of women over the age of 18 with a diagnosis of borderline personality disorder (BPD), complex mental health needs and challenging behaviour.

With trained DBT therapists, a British Isle DBT trainer and one of the first Society for DBT accredited therapists, Naseby has established expertise in treating BPD. The DBT programme is unique in that it is delivered through a complete risk managed pathway of care, creating a sense of momentum and motivation for patients.

Admission criteria

The service helps adult women, including transgender, who are 18 years+ old who have:

  • severe emotional and behavioural difficulties but with a primary diagnosis of borderline personality disorder
  • problem behaviours that are likely to include: self-harm, suicidal behaviour, problems in interpersonal relationships, substance misuse, self-neglect, fire setting and non-compliance with prescribed medication
  • treatment resistance
  • been detained under either civil or criminal provisions of the Mental Health Act 1983 (amended 2007)
  • a high risk to themselves or others.

We tend not to work with patients who are either unwilling to engage in comprehensive Dialectical Behavioural Therapy or who have a severe Learning Disability or ASD. In these instances we would try to work with individuals to help engage them in DBT over time or will endeavour to recommend another appropriate service within our charity in which to support a patient's needs.

Treatment and care

DBT is cognitive behavioural therapy (CBT) designed for individuals with complex needs. It integrates strategies from CBT with strategies of accepting reality as it is ‘in the moment’ (mindfulness).

Our treatment programme includes all five functions of a comprehensive DBT programme:
• enhancing capabilities - twice weekly skills training groups
• enhancing motivation - weekly individual therapy sessions
• ensuring generalisation - skills coaching
• structuring the environment - homework groups community meetings and staff training
• DBT consultation - (with peer group supervision) for the DBT therapists delivering treatment.

Supporting the programme, therapy intervention for patients also includes adapted therapy groups, including body image, self-catering, shopping, self-esteem, motivation and exercise and a Community/Out-reach programme supporting patient discharge. This includes DBT input via telemedicine.

Service aims and objectives

The service aims to provide:

  • A specialist solution for women with severe emotional and behavioural difficulties and a primary diagnosis of borderline personality disorder
  • Provide a recovery and rehabilitation clinical experience, with skill learning (psychological and occupational) at its core
  • Reduce hospital length of stay and readmission for this patient cohort, addressing co-morbidities and supporting community discharge.

The service admits patients who are unable to engage in an outpatient DBT programme due to their ongoing risk and need for hospitalisation, so the MDT on Naseby aims to teach skills and coping mechanisms (from the psychological and occupational programme) that enables patients to return to community settings within the shortest time possible. 

The St Andrew’s site provides an unrivalled range of facilities and leading therapeutic care. Delivered by an extensive in-house clinical team (comprising  or Psychiatry, Psychology, Dietitians, Speech and Language, Physios and physical healthcare clinicians). Patients are able to access a multitude of vocational, educational, creative and therapeutic interventions tailored to their specific mental and physical health needs. These include sport, exercise, horticulture, art and crafts and animal care.

Vocational opportunities offer patients the chance to develop work and life skills, in a fully supportive environment. Women with community leave are able to attend Workbridge (our on-site vocational centre which includes a garden centre, coffee shop, IT and design suite, woodwork and ceramics workshops) or community vocational placements.

Well-established teams

The Clinical team have extensive experience working with women diagnosed with borderline personality disorder. Alongside them is an established multi-disciplinary team with specialist knowledge and expertise. Staff regularly work across the unit ensuring that specialist skills and knowledge are shared across the service. Staffing levels remain stable and turnover low with staff reporting high engagement scores. 

Family inclusion

Carer involvement is key to patients in our care. Ensuring that they have as much information as they require (including a Carer’s Pack sent to them when their loved one is admitted) and regular contact from the Social Work team to ensure their views are heard in CPA meetings. Overnight accommodation, an onsite Carer’s Centre, as well as Family Visiting rooms are available to ensure that visits are facilitated in comfortable environments. Family members are invited to our Carer’s events with their loved ones to ensure they are part of the patient’s care.

For referrals please contact 0800 434 6690 or email admissions@standrew.co.uk

 

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