Women's Personality Disorder - low secure

Spencer South is a specialist low secure service providing comprehensive dialectical behaviour therapy (DBT) for women with personality disorder (PD).

The comprehensive DBT programme focuses on using the strategies of both acceptance and change, teaching patients the skills necessary to both understand and regulate their emotions.

Comprehensive DBT is recommended by the National Institute for Health and Care Excellence (NICE) as the treatment of choice for women with PD who repeatedly harm themselves.

Tompkins patients and staff cafe

On site hairdressers

Patient art work

On site swimming pool

Admissions criteria

We can support women over 18 who:

  • have severe emotional and behavioural difficulties with a primary diagnosis of personality disorder
  • exhibit problem behaviours likely to include self-harm, suicidal behaviour, violence towards others, problems in interpersonal relationships, substance misuse, self- neglect, fire setting and non-compliance with prescribed medication
  • are treatment resistant
  • represent a high risk to themselves or others
  • are detained under either civil or criminal provisions of the Mental Health Act.

Treatment and care

Our DBT programme started in 1997 and is well established. It was the first DBT programme to be used in a secure setting.

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 programme includes:
• 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.

Our environment complements the programme; it is built around structure, boundaries, bespoke trained staff and an occupational therapy pathway of care with a strong psychological model.

 

Next steps

Discharge is considered at admission and our clinical and social work teams work with appropriate case managers to support a transition as quickly as possible.

Our outcomes

The effectiveness of the comprehensive DBT programme at St Andrew’s has been demonstrated through a service evaluation*.

It can result in a 94% reduction in external aggression and 93% reduction in self-harm behaviours.

*A service evaluation of a one year DBT therapy programme for women with DBT, E. Fox et al, 2014

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