Approach to the treatment of Personality Disorders

People with Emotionally Unstable Personality Disorder (EUPD) have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse and eating disorders, along with self-harm, suicidal behaviours, and completed suicides.  As many as 80% of people with EUPD have suicidal behaviours, and about 4% to 9% commit suicide.  

There are a range of different treatment approaches for EUPD.  In general, treatment for EUPD aims to reduce suicidal behaviour, reduce self-harm, improve the person’s quality of life, and improve coping skills.  One such treatment is Dialectical Behaviour Therapy (DBT).  There is research evidence to support the use of DBT as a treatment for EUPD.  This is the treatment model used within Priory’s specialist Female Personality Disorder Services.

Priory Female Personality Disorder Services

The Female Personality Disorder Service within Priory specialises in the care and treatment of women with EUPD whose risk of suicide and severity of symptoms is such that treatment can only be delivered safely in an inpatient setting.  Most patients will be in treatment as in-patients for 12-24 months: the duration of treatment varying with the person’s particular and individual needs.

Dialectical Behaviour Therapy Programme

DBT is a comprehensive programme of care providing multiple treatment modalities that address the key skills and motivational deficits presented by patients with a diagnosis of EUPD. The programme has the following components:

  • Skills training (normally delivered within a group setting)
  • Individual DBT to help patients identify and solve problems while[PG1]  changing their behaviour
  • Ward milieu designed to generalise new skills into the patient’s behavioural repertoire
  • Access to DBT skills-coaching; either on the ward or via telephone consultation
  • Consultation Meeting where the therapists receive supervision and consultation on their clinical work

The DBT programme delivered at Priory Hospitals consists of the following three stages:

Pre-Treatment:

This is where the patient is orientated to the treatment, and is prepared to undertake the therapy

Stage 1:

This stage centres on the stabilisation of the individual, with a focus on decreasing para-suicidal behaviours and increasing behavioural skills

Stage 2:

The second phase of therapy is commenced when the individual is able to regulate their affect and keep themselves safe. This stage focuses on emotionally processing the past, which is particularly relevant to individuals with complex Post-Traumatic Stress Disorder or history of trauma.

Priory’s goals and outcomes for its personality disorder patients include:

  • An improved level of functioning to cope independently and improved quality of life, outside of the clinical environment
  • To understand how their personal behaviour can lead to risks to themselves
  • To be able to identify and manage “risk” situations
  • To understand their condition better and access support from community services when required
  • To be accessing age-appropriate leisure and social activities in the community
  • To enjoy healthy relationships
  • To be seeking or engaging meaningful productive activity, i.e. voluntary work, work placements or paid employment
  • To access community services to maintain a healthy, active lifestyle
  • To empower individuals to move forward to a future they have planned and worked hard for

For further information on the full range of Priory services, please call: 0845 277 4679. For professionals looking to make a referral, please click here.