Research in Practice: A women's emotional regulation group within a Community Mental Health Team

People with a diagnosis of Borderline Personality Disorder (BPD) are often excluded from and have difficulty accessing services, despite long-standing policy commitments to counter this. Those with such a diagnosis are... [ view full abstract ]

People with a diagnosis of Borderline Personality Disorder (BPD) are often excluded from and have difficulty accessing services, despite long-standing policy commitments to counter this. Those with such a diagnosis are disproportionately female and while the diagnosis itself is highly problematic, there are real challenges about the equity of mental health service provision to those in need and distress who experience intense emotions. Until recently Dialectical Behaviour Therapy (DBT) has been the main theraputic approach used within the US and the UK, though NIHCE guidelines highlight a lack of research regarding specific therapy models. DBT is resource-intensive, requiring a significant time commitment both on the part of staff and service-users, resulting in people often waiting a long time to access such groups. Systems Training for Emotional Predictability and Problem-Solving (STEPPS) was written by its American authors in part to counter some of these issues and is starting to be run as a manualised group programme in the UK for similar reasons. It has some similarities with DBT but diverges in its firm emphasis on skills-development. With two colleagues, I facilitated the 20 week STEPPS programme within secondary mental health services in our area of South West England, as a closed, women's group, with 7 group members, all of whom wanted support to manage their emotions (but not all of whom had a diagnosis of BPD). All group members reported positive changes occurring as a result of attending the group and being part of its support structure. As facilitators we took a critical stance to BPD and made significant changes to the manualised programme, rooted in our own feminist analysis. I am presenting our experience of groupwork in action, outcomes for those who attended the group and the broader implications these findings raise for service development.