Case study: dialectical behaviour therapy - Rachel's story

Rachel* is approaching the end of a year in the DBT programme and is preparing to discharge after more than a decade in hospital. Rachel is a 27 year old female with a diagnosis of borderline personality disorder (BPD), eating disorder and complex post traumatic stress disorder (PTSD). She has no known family history of mental health problems but a breakdown in family relationships from a young age meant she endured emotional, sexual and physical abuse.

She has never been employed and been in hospital on a Section 3 since December 2001 when she was 15. She was referred to social services in 1996 for difficulties in school and was detained under the Mental Health Act at the age of 15. She regularly self-harmed and took multiple overdoses in summer 2001 and was subsequently admitted to child and adolescent mental health services (CAMHS) and then at 18 transferred to in-patient adult services. At the age of 24 her behaviour escalated, becoming disturbed and high risk which led to two transfers to manage her risk. She was admitted to one of the Priory Group’s hospitals at Roehampton, in July 2012 aged 26. 

Rachel had refused therapy throughout her 12 years in hospital but accepted therapy within the Priory. She feared rejection and believed she didn’t deserve to get better. However she attended all sessions and completed individual DBT therapy, a DBT skills group, DBT skill coaching group and psychoeducation groups. She engaged in mindfulness therapy every day and extended mindfulness once a week. The therapeutic work aimed to create a life worth living for Rachel by managing her symptoms, building structure, developing skills and to respond to situations through choice.

As she prepares for discharge, Rachel is beginning to make links with the community and has established goals for her reintegration. She has developed emotion regulation skills and increased her awareness of unique warning signs. Supportive housing has also been arranged for her. 

‘I have found the skills that I have learnt within the programme very helpful and think they will help me to have a much happier life outside of hospital. I am very grateful for these skills.’ Rachel

For further information on the full range of Priory services, please call: 0845 277 4679.

*Name has been changed to protect identity