Exploring staff perceptions of the utility of clinician connections when working with emotionally dysregulated clients

• Main Authors: Lucy Burke, Mary Kells, Daniel Flynn, Mary Joyce
• Format: Article
• Language: English
• Published: BMC 2019-07-01
• Series: Borderline Personality Disorder and Emotion Dysregulation
• Subjects: Family connections; Clinician connections; Borderline personality disorder; Dialectical behaviour therapy
• Online Access: http://link.springer.com/article/10.1186/s40479-019-0109-0

Abstract Background Borderline personality disorder (BPD) is considered to be a challenging condition for clinicians to treat. Clinicians routinely working with individuals who experience severe emotional dysregulation often do not receive appropriate training and support to work with this client group. This article describes an intervention, Clinician Connections (CC), which was developed to support practitioners who work with individuals with BPD. CC aims to increase practitioner’s knowledge of BPD, develop a skillset to work with emotionally dysregulated individuals and enhance practitioner’s self-efficacy with regard to working effectively with this client group. The aim of this study is to investigate the perceived utility and acceptability of CC, and identify areas for further development of the intervention. Method A seven-hour CC workshop was provided to Emergency Department and community mental health clinicians. Three focus groups were completed following completion of the intervention with 13 clinicians (12 female; 1 male) and were audio recorded. The study utilised a thematic analysis framework. Results Six master themes emerged from the focus group data which included 10 subordinate themes. The master themes identified were: the need for training; a new understanding; validation; barriers to applying new skills; overcoming barriers to skill application; and future direction: practical application of skills. Participants reflected on how their new understanding of transactions and their own experiences affects their practice. They also noted improved client interactions and client relationships resulting from the use of validation. While there was an increase in participants’ self-efficacy in working with individuals with BPD, a need for further skills and practice was also highlighted. Conclusion The evidence presented here suggests that CC is both beneficial and feasible. Qualitative feedback suggests there is a need for further support in the strengthening and generalisation of skills. Suggestions were made by practitioners regarding potential improvements to the delivery of the workshop. Future research could evaluate the changes made to CC and focus on a quantitative approach to quantify the impact of CC.