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Beyond the walls of Camden & Islington personality disorder service: a qualitative study of clinical consultation to external services
Psychoanalytic Psychotherapy ( IF 1.2 ) Pub Date : 2021-08-03 , DOI: 10.1080/02668734.2021.1953116
Andrew White 1 , Abi Herbert 1 , Pierise Marshall 1
Affiliation  

The Camden and Islington Personality Disorder Service (PDS) increasingly provides clinical consultation to external services. There is a dearth of research on the experience of clinicians delivering such consultation. Interviews were conducted with clinicians from the PDS, and a semantic Thematic Analysis was conducted on transcripts to answer the question, ‘What is the experience of Personality Disorder Service staff providing input to staff in external services?’ 13 sub-themes under four overarching themes were identified (these latter were: Anxiety, Fragmented Co-working, Task Difficulty, and Positive Outcome). These themes provide an overview of the experience of consulting clinicians. Themes are explored through Kleinian psychoanalytic theory, with reference to Bion’s work on containment and groups. Findings suggest that staff need to retain thinking space to work effectively, to feel safe and recover a sense of competence when it is attacked, highlighting the need for access to structures such as supervision. The responsibility for trying to reduce distress, risk (to self, to and from others) and functional disability of people with a diagnosis of personality disorder cannot belong to one person or service but services need to be able to think together to gain a better understanding and have an agreed cross-service response.



中文翻译:

超越卡姆登和伊斯灵顿人格障碍服务的界限:对外部服务的临床咨询的定性研究

卡姆登和伊斯灵顿人格障碍服务中心 (PDS) 越来越多地向外部服务提供临床咨询。缺乏关于临床医生提供此类咨询的经验的研究。与 PDS 的临床医生进行了访谈,并对笔录进行了语义主题分析,以回答“人格障碍服务人员向外部服务人员提供意见的体验是什么?”的问题。确定了四个总体主题下的 13 个子主题(后者是:焦虑、分散的合作、任务难度和积极成果)。这些主题概述了咨询临床医生的经验。通过 Kleinian 精神分析理论探索主题,参考 Bion 在收容和团体方面的工作。调查结果表明,员工需要保留思考空间才能有效工作,感到安全并在受到攻击时恢复胜任感,这突出了获得监督等结构的必要性。试图减少被诊断为人格障碍的人的痛苦、风险(对自己、对他人的风险和来自他人的风险)和功能障碍的责任不能属于一个人或一个服务,但服务需要能够共同思考以获得更好的理解并有一个商定的跨服务响应。

更新日期:2021-09-01
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