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Borderline Personality Disorder in Female Patients Report (Assessment)


Introduction: Background and Essential Information

Personality disorders rank among the mental issues that are currently on the rise, according to the statement made by the National Institute of Mental Health (National Institute of Mental Health). The Borderline Personality Disorder (BPD) can be deemed as one of the most common occurrences that, nevertheless, lead to significant negative implications (Goodman et al. 112). The fact that female patients are affected by the disorder shows that there is a specific vulnerable population whose needs must be addressed accordingly (Bertsch et al. 426). Therefore, there is an urgent need in exploring the subject matter closer so that new strategies for addressing it could be designed successfully. The practice carried out at Cambian Alders Clinic (CAC), Gloucester, UK has shown that the promotion of self-management among patients, as well as the use of the Dialectical Behavioural Therapy (DBT), is overly exaggerated as far as its success in managing BPD is concerned. (Andreasson et al. 522). Therefore, the experience can be viewed as the crucial step toward developing a new and improved approach toward improving patient outcomes.

In retrospect, the experience that I had at the hospital was twofold. On the one hand, it pointed to the areas on which I had to work in order to improve my skills. On the other hand, it provided a deeper insight into the problems that the contemporary strategies of managing the BPD in women had, therefore, shedding light on how I could possibly contribute to the improvement of the target area as a healthcare expert. Therefore, the practice that I had at CAC served as the foundation for my further evolution as a healthcare provider.

Practice Description: Patients and Their Concerns

As a Mental Health Support Worker (MHSW) at CAC, I had to carry out the suggested healthcare plans for women with BPD, as well as monitor the changes in the patients’ behaviour and report the observed phenomena to the therapist so that the appropriate actions could be taken. Furthermore, active promotion of physical and mental well-being was necessary along with active us of a patient-centred care approach. Thus, the foundation for significant improvements in the quality of mental care could be created, and more satisfactory patient outcomes could be achieved.

The observations carried out during the practice at CAC have shown that the application of DBT has not led to significant improvements in the target are. Particularly, the female patients suffering from BPD have not gained the required degree of independence as far as the choice of the appropriate behaviours is concerned, nor did they get rid of their suicidal tendencies (Gratz et al. 31). While their situation did not aggravate after the application of the said approach, the same support techniques of the same intensity had to be provided to prevent the incidences of suicide among the target population. Regular counselling and psychological assistance were offered to the target population, yet the patients remained at the same stage of BPD development, requiring more efficient strategies (Biskin and Paris 1791).

It was also suggested that the Schema-Focused Therapy (SFT) as the basis for improving the outcomes among patients with BPD was bound to lead to better effects (Malogiannis et al. 322). The fact that the identified approach allows creating a treatment package shows that it may possibly trigger positive long-term effects. Therefore, the identified strategy needs further studies, as the practice outcomes have shown (Leichsenring et al. 364).

Practice Evaluation: Performance and Communication

In retrospect, the practice carried out at CAC was quite successful. For instance, the essential tasks that I had to complete as the MHSW were accomplished accordingly. Particularly, the process of patient monitoring was carried out efficiently with the help of appropriate tools (i.e., close supervision, detailed records of the patients’ behaviour, analysis of the key trends in the behavioural changes, etc.). Furthermore, the provision of the daily care for the target population also met the set quality standards. Particularly, the quality of the patients’ lives was set at the appropriately high level by providing them with support and helping them accomplish their daily activities such as bathing, eating, and movement, in a more general sense (Sanchez and Moges 187).

There were also several instances of physical violence which were addressed accordingly and managed successfully. Particularly, the patients were provided with second-generation antipsychotics along with extensive therapy so that the opportunities for controlling further instances of aggression could become a possibility. The refusal from the traditional first-generation sedatives as the primary tool for controlling the patients’ actions can be viewed as a significant step forward and the chance to provide the patients with a certain amount of independence. As a result, a more successful management of mental disorders became possible in the environment of CAC (Lacey et al. 4).

Finally, putting a stronger emphasis on the role of families in therapy sessions carried out in the context of the hospital could be considered an essential step in promoting a faster recovery. Therefore, overall, the practice can be considered rather successful. One must mention, though, that there were some problems such as the failure to take the cultural specifics of the patients’ background into account when implementing the intervention. For instance, in case of an African American patient, the significance of family ties as an important cultural characteristic was omitted, leading to a prolonged therapy (Harper et al. 18).

What Has Been Learned: The Information Acquired in the Process

My experience at CAC provided a deep insight into the job of an MHSW and shed a lot of light on the issue of managing patients’ needs. Particularly, I have realised that every single case needs to be addressed with the patient’s unique cultural background in mind. The significance of understanding the target population’s culture is crucial since it informs the MHSW about the tools that can be used to promote a faster recovery of the patient and determines the choice of a particular strategy (Barksdale et al. 371).

Furthermore, the importance of family and community support has been revealed during my practice as an MHSW in the CAC environment. While the gravity of failing to invite family members to participate in the patient’s recovery process has been known or quite a while, the importance of the community support still needed to be tested (Pang et al. 35). The practice, in its turn, served as a perfect tool for proving that the community support and assistance, in fact, creates the foundation for a faster recovery of the patient (McGorry et al. 10).

Finally, the necessity to promote cooperation among healthcare providers in the environment of a specific facility has become evident to me while I was performing as an MHSW in CAC. A range of processes occurring in the identified setting, from patient handovers to the provision of interventions, required that a significant amount of data, including the patient’s personal information, should be transferred from one healthcare expert to another. Therefore, there was a consistent need in deploying the tools that could allow for handoff communication, storing the relevant data, transferring it successfully, etc. My practice at CAC, therefore, showed that it was imperative to introduce modern IT tools, such as corporate networks and IT devices to improve the quality of data management (Berzin et al. 5).

New Skills and Abilities: Developing Crucial Habits

In the course of the practice, I have developed a range of new skills and abilities. For instance, I have gained the ability to engage in active listening. Working with mental health patients, I realised that it was crucial to take active part in the process of listening to the target audience. Thus, the necessity to develop the appropriate skills emerged. As a result, I have acquired the ability to prompt people to start a conversation, express their ideas, fears, and concerns, etc. (Gallagher et al. 3).

The decision-making skills have also been improved significantly over the course of working at CAC. For instance, I am capable of identifying the relevant factors and passing my judgment to address a particular problem much faster than it used to take me several months ago. As a result, the needs of the target population can be met within a much shorter amount of time, leading to improved patient outcomes (Orza et al. 58).

Finally, the ability to engage in active learning should be viewed as one of the essential skills learned in the course of practice at CAC. There is no secret that every case is unique, and experience defines the success of MHSW’s efforts to a considerable degree. By focusing on acquiring new knowledge and skills on a regular basis, I started engaging in lifelong learning, thus, building a profound basis for further professional development (Lubben et al. 3).

Opportunities to Pursue: The Course for the Further Progress

Wirth the acquisition of new skills, I got a chance at exploring new opportunities as an MHSW. Particularly, the possibility of continuing my professional development by practicing the newly acquired skills in the identified healthcare setting deserves to be mentioned. Equipped with the knowledge and abilities acquired during the previous practice, I am now fully capable of applying the said skills to solve new and more challenging dilemmas faced by MHSWs in the context of a healthcare facility. For instance, I can resolve the problems associated with managing the needs of female patients with mental issues more efficiently (Diamond et al. 431).

Furthermore, the chances to explore the cultural specifics of the target patients and the way in which these characteristics affect the application of various healthcare practices need to be listed among other opportunities. With a significant amount of knowledge about the role of multiculturalism in meeting the requirements of female mental patients, I will be capable of providing the interventions that will lead to a gradual improvement of patient outcomes. Thus, a more efficient framework for managing the target population’s needs will be created.

Finally, I feel that the experience described above served as a powerful impetus for the further learning, Therefore, I am positive about the idea of lifelong learning as the foundation for my future career. The opportunity to explore new horizons in mental healthcare excites me, and I feel compelled to study the target area with even greater diligence. I feel that, being equipped with the new concept of lifelong learning as the basis for addressing the needs of a diverse population, I will be able to make a difference in the area of female mental healthcare (Morrison et al. 8).

Conclusion: Retrospect and Implications for the Further Practice

Promoting improvement in the area of mental healthcare and growing professionally is a challenging task, yet practice outcomes can serve as the guide in the identification of further goals and milestones. In my case, working at CAC and MHSW became the basis for identifying my further development as lifelong learning and consistent acquisition of the relevant skills. The reason for the identified objective concerns the necessity to meet the high-quality standards of the contemporary multicultural healthcare environment.

Moreover, the practice at CAC proved that it was crucial to develop the communication skills that would compel the target population to share their concerns with the MHSW. By engaging in active listening, one can convince the patient to confide in the MHSW, thus, creating a bond that will, later on, become the foundation for a successful therapy.

The significance of community and especially family support should also be listed among the key insights of the practice. Although the concept itself is not new, the importance of helping the patient build a connection with the community members is often overlooked, and the family members often do not have the skills required to engage the patient in the process of regaining social skills. The collaboration between the MHSW, the family members, and the community, therefore, must be viewed as the foundation for a successful intervention and the further improvement of patient outcomes. Thus, the experience at CAC was truly inspiring. It became a significant step on my way to becoming an MHSW and allowed me to gain not only the relevant skills and knowledge but also confidence necessary to assist female patients with mental health concerns.

Works Cited

Andreasson, Kate, et al. “Effectiveness of Dialectical Behaviour Therapy Versus Collaborative Assessment and MANAGEMENT of Suicidality Treatment For Reduction of Self-Harm in Adults with Borderline Personality Traits and Disorder – A Randomized Observer-Blinded Clinical Trial.” Depression and Anxiety, vol. 33, no. 6, 2016, pp. 520-530.

Barksdale, Crystal L., et al. “Addressing Disparities in Mental Health Agencies: Strategies to Implement the National CLAS Standards in Mental Health.” Psychological Services, vol. 11, no. 4, 2014, pp. 369 –376. doi::10.1037/a0035211

Bertsch, Katja, et al. “Reduced Plasma Oxytocin Levels in Female Patients with Borderline Personality Disorder.” Hormones and Behaviour, vol. 63, no. 3, 2013, 424-429. doi:10.1016/j.yhbeh.2012.11.013

Berzin, Stephanie C., et al. Practice Innovation through Technology in the Digital Age: A Grand Challenge for Social Work. American Academy of Social Work and Social Welfare, 2015.

Biskin, Robert S., and Joel Paris. “Diagnosing Borderline Personality Disorder.” CMAJ, vol. 184, no. 16, 2012, pp. 1789–1794. doi:10.1503/cmaj.090618

Diamond, Diana, et al. “Attachment and Mentalization in Female Patients with Comorbid Narcissistic and Borderline Personality Disorder.” Personality Disorders: Theory, Research, and Treatment, vol. 5, no. 4, 2014, pp. 428–433. doi:10.1037/per0000065

Gallagher, Elizabeth, et al. “How can Community Residential Services Effectively Support Adults with Intellectual Disabilities who Present with Challenging Behaviour and/or Mental Health Problems?” Austin Journal of Nursing & Health Care, vol. 1, no. 1, 2014, pp. 1-3.

Goodman, Marianne, et al. “Dialectical Behaviour Therapy Alters Emotion Regulation and Amygdala Activity in Patients with Borderline Personality Disorder.” Journal of Psychiatric Research, vol. 57, no. 1, 2014, pp. 108-116. doi:10.1016/j.jpsychires.2014.06.020

Gratz, Kim L., et al. “Mechanisms of Change in an Emotion Regulation Group Therapy for Deliberate Self-harm among Women with Borderline Personality Disorder.” Behaviour Research and Therapy, vol. 65, no. 1, 2016, pp. 29-35. doi:10.1016/j.brat.2014.12.005

Harper, Erin, et al. “Practitioners’ Perceptions of Culturally Responsive School-Based Mental Health Services for Low-Income African American Girls.” School Psychology Forum: Research in Practice, vol. 10, no. 1, 2016, pp. 16-28.

Lacey, Krim K., et al. “The Mental Health of US Black Women: The Roles of Social Context and Severe Intimate Partner Violence.” BMJ Open, vol. 5, no. e008415, 2015, pp. 1-13. doi:10.1136/bmjopen-2015-008415

Leichsenring, F., et al. “The Emerging Evidence for Long-Term Psychodynamic Therapy.” Psychodynamic Psychiatry, vol. 41, no. 3, 2013, pp. 361-384. doi:10.1521/pdps.2013.41.3.361

Lubben, James, et al. “Social Isolation Presents a Grand Challenge for Social Work.” Grand Challenges for Social Work Initiative, vol. 1, no. 1, 2015, pp. 1-20.

Malogiannis, Ioannis A., et al. “Schema Therapy for Patients with Chronic Depression: A Single Case Series Study.” Journal of Behaviour Therapy and Experimental Psychiatry, vol. 45, no. 3, 2014, pp. 319-329. doi:10.1016/j.jbtep.2014.02.003 0005-7916

McGorry, Patrick, et al. “Response to Jorm: Headspace – A National and International Innovation with Lessons for Redesign of Mental Health Care in Australia.” Australian & New Zealand Journal of Psychiatry, vol. 50, no. 1, 2016, pp. 9–10. doi:10.1177/0004867415624553

Morrison, Laura, et al. Harnessing the Learning Community Model to Integrate Trauma-Informed Care Principles in Service Organizations. New York University Silver School of Social Work, 2015.

National Institute of Mental Health. Any Personality Disorder. 2017, www.nimh.nih.gov/health/statistics/prevalence/any-personality-disorder.shtml. Accessed 10 June 2017.

Orza, Luisa, et al. “How Does Living with HIV Impact on Women’s Mental Health? Voices from a Global Survey.” Journal of the International AIDS Society, vol. 18, suppl. 5, 2015, pp. 56-64. doi:10.7448/IAS.18.6.20285

Pang, Sing M. C., et al. ” Health Outcomes, Community Resources for Health, and Support Strategies 12 Months after Discharge in Patients with Severe Mental Illness.” Hong Kong Medical Journal, vol. 21, no. 2, 2015, pp. 32-36.

Sanchez, Celia, and Nurilign Abebe Moges. “Level of Mental Health Service Integration in Primary Health Care Units in Debre Markos Town, Ethiopia, 2014.” Science Journal of Public Health, vol. 3, no. 2, 2015, pp. 181-190. doi:10.11648/j.sjph.20150302.15

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