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

What is it about?

Improvement is sorely needed to NHS care for people with Trauma Induced Emotional Regulation and Interpersonal relational difficulties (TIERI); currently labelled as a variant of Personality Disorder (PD). An evaluation demonstrated the benefits of offering 495 staff three-day trainings with a clinician-designed, unique training package. Statistically significant improvements were reported in both staff confidence and optimism when dealing with people with a diagnosis of personality disorder (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. 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. Given the expense of staff time and resources, this evaluation shows the resultant positive changes achieved. Teaching 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. Positive changes resulted from a mixed-methods evaluation of three-day trainings using a specially designed training package.

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