Training NHS staff to work with people with trauma induced emotional regulation and interpersonal relational difficulties (TIERI)/borderline personality disorder

Abstract

Purpose Improvement is sorely needed to the National Health Service (NHS) care for people with trauma induced emotional regulation and interpersonal relational difficulties (TIERI), currently labelled as a variant of personality disorder [PD; borderline personalty disorder/emotionally unstable personality disorder (BPD/EUPD)]. This study aims to improve staff training. Design/methodology/approach A mixed-methods evaluation demonstrated the benefits of offering 495 staff three-day trainings with a clinician-designed, unique training package. Findings Statistically significant improvements were reported in both staff confidence and optimism when dealing with people with a diagnosis of PD (PWDPD) and scores on the Helping Alliance questionnaire. No statistically significant changes in social attitude resulted. Qualitative data shows negative descriptions generated by staff decreased post-training with an increase in positive and neutral descriptions. The responses generated six different themes: resources, client demand, medical model, emotional, human and positive rewards. Differing proportions were found pre and post-training. Research limitations/implications This was a clinical-world evaluation, not a formal research project. Different pairs/combinations of experienced clinicians (predominantly clinical psychologists) acted as trainers. Some minor variation occurred within the training package used and presentation. Practical implications Given the expense of staff time and resources, this evaluation shows the resultant positive changes achieved. TIERI staff about the difficulties experienced by PWDPD and how to negotiate the relational dynamic is essential. Training helps improve staff perception of the people involved, improves staff confidence and promotes better therapeutic alliances (key to providing the relational and trauma work needed). Ongoing supervision is likely needed post-training. Originality/value Positive changes resulted from a mixed-methods evaluation of three-day trainings by using a specially designed training package.