Nettle, F1

1 Northern Community Mental Health, NALHN, SA Health


Background and aims: The NALHN Borderline Personality Disorder Service Plan (June 2019) proposed a stepped model of care (MOC) in Community Mental Health. The goal of this project was to evaluate a 12-week group program for people with BPD (“12-Week BPD Group”), which forms step two of the MOC. Depending on outcomes of the evaluation, it was anticipated this program may be rolled out to both NALHN mental health sites as part of the stepped MOC.

Methods: 7 participants with BPD were assessed as suitable and offered a place in the 12-Week BPD Group. Participants were recruited from people who had been referred to the DBT Skills Group living in the NALHN catchment area. Participants were aged 21-58 years, 6 female and 1 male. People with active psychotic symptoms, significant antisocial traits, or cognitive impairment were not included. Evaluation was based on clinical outcome measures (K10, Borderline Symptom List 23, BSL – Supplement: Items for Assessing Behaviour, Emotion Regulation Scale – 18, WHO Quality of Life-BREF), client feedback, and clinician feedback. Qualitative feedback was collated and descriptive statistics were used to summarise the evaluation data.

Results: On average there were no significant differences on the clinical outcome measures. Qualitative feedback was centred on the value of supportive peer interactions, criticism of group structure; expectations as a barrier; limited uptake of skills and insufficient behavioural change.

Conclusions: Outcomes of this study will be used to inform and implement the stepped MOC. Communication with clients will be key in managing expectations of care.

Frances Nettle

Frances is a Senior Clinical Psychologist at Northern Community Mental Health, NALHN. Frances has worked in community mental health settings for the past 7 years, during which time she has specialised in working with people with Borderline Personality Disorder (BPD). As part of her role, she co-ordinates the Dialectical Behaviour Therapy program in NALHN and has recently been involved with development of a stepped Model of Care for people with BPD. Frances brings a warm, empathetic and expert approach to working with highly complex BPD presentations. She is passionate about supporting the growth and development of new and emerging clinicians with a specialised interest in BPD.

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