Reducing patient stigma amongst staff working with personality disorder

INTERVENTION: Psycho educational training (PETr) intervention. We focused our training efforts on providing an introductory understanding of the diagnosis and the treatment of PDs. We taught using informal presentations, pitched at the professional and educational demographic of our participants, with group discussion as required to clarify content. During the first day, we introduced DoH guidelines, reviewed types of PD and described how clinicians assess and classify them. We discussed theoretical accounts of the development of PDs, focusing on biosocial and genetic factors. During the second day, the evidence base for current treatments was reviewed. Additionally, we showed videos of PD patients describing their treatment experiences and reflecting on the kind of care they would like to receive. Overall, the content of PETr workshop emphasised participants? work‐related experiences of PD clients in terms of service‐related issues, rather than their personal feelings about them. Acceptance and commitment training (ACTr) intervention. This training intervention sought to help staff to understand the origins of the negative private experiences sometimes triggered by their patients, mindfully noticing them as they occurred, and understanding that they are unavoidable consequences of their challenging work. Once difficult thoughts could be self‐compassionately accepted, the training moved towards helping staff to reconnect with their professional and personal values and letting these guide their actions. A role play video of a staff member working with a PD patient was also shown to demonstrate some ACT principles. During the final part of the workshop we offered participants the opportunity to identify any aspect of their behaviour that they wanted to change in the service of leading a more values‐consistent life, and make a public commitment to it. Total duration of the actual interventions were 2 days. The study period was a total of 6 months (for both interventions). CONDITION: Patient stigma amongst staff working with personality disorder. ; Mental and Behavioural Disorders ; Personality disorder PRIMARY OUTCOME: 1. Attitude to Personality Disorder Questionnaire (APDQ; Bowers & Allan, 2006). We used the 40‐item APDQ to assess stigmatising attitudes towards clients with a PD. ; 2. Helping Alliance Questionnaire?Therapist Version (HAQ‐II; Luborsky et al., 1996). We used the 19‐item HAQ‐II to measure the quality of the therapeutic relationship from the member of staff?s perspective. ; 3. The Social Distancing Scale (SDS; Link, 1987). We modified the 7‐item SDS by replacing all references to ?mental illness? with ?personality disorder?, and used the revised version to assess the extent to which staff distanced themselves from their PD clients.; ; All outcomes were measured at the same time points: baseline, post‐intervention and at 6‐month follow‐up. INCLUSION CRITERIA: All mental health staff employed by NHS trusts and staff from other agencies who come into contact with PD patients were eligible to volunteer to participate. SECONDARY OUTCOME: 1. Maslach?s Burnout Inventory (MBI; Maslach, Jackson, & Leiter, 1997) We used the 22‐item MBI to measure staff burnout. Higher scores indicate higher burnout.; 2. General Health Questionnaire (GHQ; Goldberg, 1997). The GHQ measures psychological distress were assessed using the 22‐item scale, with higher scores indicating higher distress.; 3. Valued Living Questionnaire (VLQ; Wilson, 2008). The VLQ assesses the degree to which respondents? actions are consistent with their values. Lower scores indicate less discrepancy between values and actions. ; ; Control measures.; 1. Marlowe‐Crowne Questionnaire (MCQ; Marlow‐Crowne, 1964). The 8‐item was used to assess the degree to which staff tended to act in socially desirable ways in their lives. In addition, ; 2. Credibility and Expectancy Questionnaire (CEQ; Devilly & Borkovec, 2000). The 6‐item CEQ was administered before training to ascertain whether participants had any preconceived perceptions about the training.; ; All outcomes were measured at the same time points: baseline, post‐intervention and at 6‐month follow‐up. The Credibility and Expectancy Questionnaire was measured at baseline only.