This paper reports on the literature published on staff attitudes towards the borderline personality disorder CSPO) diagnosis over time, and research on training programmes to address attitudes towards this client group. Following a computerised literature search, ten articles were identified on staff attitudes towards SPD, with four identified on training programmes to address such attitudes. Review of the literature revealed a focus on nurses' attitudes, with relatively consistent negative staff attitudes found towards BPD. Findings suggested this was generally due to lack of understanding of the client group, with staff indicating a need for more training/education. Training programmes produced promising results in improving staff attitudes towards BPD, but these improvements were not well maintained over time. Future research should focus on what makes this client group more challenging than others, and also the perspectives of other mental health professionals. Further research is also required on the long-term effectiveness of training programmes on BPD.

Introduction: The research base for Acceptance and Commitment Therapy (ACT) has some promising, though early, findings for treating individuals with "treatment resistant" difficulties, including Borderline Personality Disorder (BPD) (see Morton et a1.,2012). Theories of BPD claim emotional regulation difficulties are stable and lie at the heart of the diagnosis, with distress persisting throughout adulthood (Zanarini et aI., 2003). ACT theory posits that acceptance and willingness to experience intense emotions would allow one to engage with a valued life alongside such distress. Theoretically. this concept may present a particular challenge to individuals with BPD, where high levels of experiential avoidance have been found to fully mediate the relationship between BPD features and intense emotional affect (Gratz, TuB & Gunderson, 2008). This research seeks to understand if and how people diagnosed with BPD experience acceptance of intense emotions, and, using pre- and post-therapy interviews, how this may change following a pure-ACT intervention. Method and Analysis: A phenomenological design was adopted to explore if and how participants with BPD experience acceptance of intense emotions. Semi-structured interviews were conducted before and after a 12-week ACT group with a homogenous sample (N::6), and Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009) was utilised to explore the process of change.

This thesis examines mental health professionals' responses toward patients diagnosed with Borderline Personality Disorder (BPD) and presents a qualitative study of Dialectical Behaviour Therapists' (DBT) experiences in their work with young people with BPD features. A review of empirical literature regarding emotional, behavioural and attitudinal responses of professionals toward these patients identified a range of negative responses, distinguishable from responses toward patients with other mental health problems. The review highlights the consistency of responses in professionals working in a variety of roles with these patients in countries across the world, and points to the need for further research to understand the precipitants of these negative responses. Controversy surrounds the diagnosis of BPD during adolescence and hence the majority of research in this area focuses upon professionals working with adult patients. On the basis of evidence regarding the presence of BPD features during adolescence and the application of therapeutic approaches, such as DBT, to young people exhibiting these features, the empirical paper presents an Interpretative Phenomenological Analysis (IPA) of the lived experience of DBT therapists in this context. A super-ordinate theme of 'the impact of the therapy on the therapist' containing five sub-themes is presented.

Ruptures can be seen as potential change events in therapy that can result in positive or negative consequences for the therapeutic alliance and treatment outcome, depending on how, or it; they are successfully resolved. If the therapeutic alliance is to withstand die inevitable ruptures that occur, therapists need to be able to detect and effectively manage ruptures. Only a limited number of studies have researched in detail the actual process of rupture resolution in psychotherapy. This study is validation-oriented and aims to test an empirical model of rupture resolution (Bennett et al. (2006) Refined Performance Model) used in cognitive analytic therapy (CAT). It does so by examining the occurrence of ruptures in selected good and poor evaluation sessions and the interventions of CAT therapists in their attempts to resolve ruptures, among an adolescent client group at risk of developing Borderline Personality Disorder (BPD).

This study investigated the discharge practice of a Community Mental Health Team (CMHT) by examining records (electronic and file) of clients discharged between April 2005 and March 2006. Out of a total of 211 discharged clients a random sample of 20 clients was selected to examine the extent to which records and reasons for discharge adhere to current CMHT policies and guidelines. In addition, a sample of clients who had been engaged by the CMHT for 6 months or less was compared to a sample of clients who have been engaged for 1 year or longer to establish whether these differed in sociodemographic characteristics, diagnoses and extent of service provision. The majority of clients discharged during the specified period consisted of clients engaged for 6 months or less. The sampling process revealed that a proportion of these included clients seen for one-off assessments or duty calls, indicating that there is room for improvement to clarify referral criteria (e.g. to GPs) and the role of the CMHT. Similarly, the examination of recording practice also revealed room for improvement in the closing of care packages electronically and inclusion of required information in discharge letters. Almost 50% of clients in the sample were discharged following a decline of any further intervention the reasons for which it will be important to investigate in the form of an audit or survey of service user’s views. Clients engaged for 6 months or less and 1 year or longer seemed to differ mostly in terms of employment rates, diagnosis and previous inpatient admission and mental health act sections. The findings are discussed in relation to the limitations of this study, implications for the service and further research.

Clinical and theoretical literature suggests that some people who present with psychological problems have a poorly developed sense of their own identity. It has also been suggested that cognitive theory and therapy does not always adequately identify, conceptualise, and address these identity problems. The current study aims to develop a self-report questionnaire measure to assess these identity problems. It also tests some specific hypotheses about the relationship between identity problems and other psychological constructs, including borderline personality disorder symptomatology. anxiety and depression.