Northants Personality Disorder Hub

Dialectical Behaviour Therapy for Young People and Their Family or Carers

The Personality Disorder Hub is now providing Dialectical Behaviour Therapy (DBT-A) for young people and adolescents with emotional regulation difficulties and their families or carers.

Referrals for this service are made via our CAMHS service and begin with an initial consultation to assess individual needs and establish whether DBT-A is a suitable intervention.

If DBT-A is the right course of treatment, the young person will begin therapy which following assessment and pre-commitment phase, comprises of weekly individual sessions, weekly DBT skills training group and access to telephone skills coaching (young person and supporting adult).

DBT is a model based on balancing the dialectic of acceptance and change, teaching skills in relation to managing distress, learning to regulate emotions, and navigating relationships and effective communication. Mindfulness weaves through the entire programme under the premise that we cannot change that which we can't first observe. Our overall aim being to help clients to 'build a life worth living.'

Dialectical Behaviour Therapy For Adolescents (DBT-A) and their family/carers [pdf] 355KB

You can also watch the video below which is an introduction to DBT-A (Dialectical Behaviour Therapy for Adolescents, Young People and Families):

For more information call 03000 271012.

DBT-A Patient Stories

Children and Young People 

"Out of all the groups and therapies I've done this one has been the most helpful because it actually teaches you something, I'm not just sat here yapping I'm actually learning. You have to realise it's up to you if you want to change something." 

"DBT was one of the best things I have done recently. Just go for it. It gets better. Share, it helps. DBT is not daunting. It is quite practical." 

"It would benefit loads of people that don't know about it and the hardest bit is that they don't know about it. Initially I thought its not gonna do anything because I was in that mindset. When you finish it you realise how much it does actually help. It helps with your emotions and how to not snap at people you would snap at normally. I think it would benefit a lot of people who are really struggling." 

"At first it was a bit overwhelming having individual and group so it was a bit all over the place, but it settled down and turned into a routine. It was helpful to go to group because my socialising skills got a lot more better and I got more relaxed talking to people I didn't know well and got to know [them]. Individual [sessions] was helpful if I was still a bit confused I could talk about it there and what I was struggling with things I could break that down." 

"It is quite different to a lot of other therapies because it changes the way you think and just makes your life easier."

Supporting Adults

"I think that this might put people off - sharing something in front of a group but it is one of the best things. You are all sharing and no one is judging. You might have done it [the skill] wrong and you share it and get guidance; that's the whole point. You aren't the only one. Last year I thought why us? Why this? What did I do? But when you come here you see you aren't the only one. You talk to parents, not about anything personal or deep, but you get to see little traits and think my child does this. All of a sudden you aren't the odd one out."

"It was nice being on the journey and learning together. There has definitely been a marked improvement. It was nice to be able to work through it together when we didn't understand."

Family Connections Programme

Families and carers of people with Borderline Personality Disorder (BPD) have access to a skills-based programme provided by Northamptonshire Healthcare NHS Foundation Trust (NHFT). Please only apply if you or your loved one lives in Northamptonshire.

Family Connections is a 12-week programme developed by the National Education Alliance for Borderline Personality Disorder (NEABPD). NHFT's Personality Disorder Hub is offering this programme to families and carers across Northamptonshire who have loved ones experiencing BPD.

It will provide participants with current information, teaches coping skills and create the opportunity to develop a support network amongst peers.

The 12-week course focuses on skills training based on Dialectical Behaviour Therapy (an evidence-based therapy to treat borderline personality disorder). It also covers relationship mindfulness and effective communication. The classes allow group participants to obtain information and practice the application of skills in a confidential and supportive environment.

Courses are run twice a year (Spring and Autumn). This workshop isn't available to people who suffer from BPD, only to adult family members and close friends whose loved ones live in Northamptonshire.

To find out more about Family Connections and arrange an initial telephone appointment call 03000 271012.

The sessions will be delivered remotely via Zoom

Family Connections leaflet - Borderline Personality Disorder[pdf] 356KB

Understanding and Managing Emotions

Our team provides 'Understanding and Managing Emotions' (U&ME) group training for individuals with difficulties regulating their emotions, difficulties with interpersonal effectiveness and difficulties managing crisis situations.

It is an 18-week programme based upon 'taught skills' rather than a therapy group. It is a standalone group therefore all skills are taught in group only.

Referrals for this service are made via the Community Mental Health Team (CMHT). They begin with an initial consultation to assess individual needs and show whether U&ME is a suitable intervention.

For more information, please call 03000 271012.

Patient Stories

Lewis

Dialectical behavioural therapy (DBT) is the best form of treatment mental health wise I have received. In my time in services, I have been given different medication after medication and none of them really worked. I am not stating medication doesn't have its place for me, it was not the answer. Medication helped keep me safe but DBT helped me get my life back.

Starting DBT is a very brave move. Change is hard. Wanting to set goals and change your life takes courage. I know from personal experience sometimes it is easier to accept being unhappy. If you give DBT your all and want to make your life better it works. Like all good change, it will not happen straight away. It is hard to walk into a group of people you do not know. The thing to remember is everyone in the room has been at that point at some time. Everybody has nerves but it is worth pushing them aside for the bigger picture.

Things to remember:

• DBT is the start of getting your life where you want it.
• DBT can change your whole outlook on life.
• The goals you have set can be met if you want them.
• Support is always there if you need it.

If you have chosen to do DBT you are already on the right track. By accepting the need to change you acknowledge your life is not where you want it to be. The great thing is you are doing something about it. You deserve the chance to have a life worth living and need to hold onto this fact.

The group and one-to-one sessions made me actually feel and accept my emotions. I always had this view that I couldn't let people in or allow myself to feel emotions. I now know it is ok to let people in. Having emotions and showing them does not make anyone weak. Another myth of emotions is letting people in means telling your life story. Always remember your past is yours. DBT helped me view my past as experiences.

Another way to look at the skills you learn is as a tool kit. We all know at times you need different size screws to do DIY for example. DBT teaches skills that help you get through life and is why it is like a tool kit.

1. Skills (learned)
2. Which you can change to suit you
3. Life becomes easier
4. After a while, you start using skills without even thinking about it 

What DBT has done for me?

I have accepted my past and put it where it belongs, in the past. My reactions to situations have changed. I no longer carry so much anger around with me, stupid judgements about myself have gone. I look at the longer view. Relationships are better because I can stick to my values but give reasons for my point of view. I have goals and they are now down to me to achieve. My life has become worth living but I know there is room to grow.

The most important thing DBT has taught me is that life is beautiful. I have had low points and high points. Going forward I have a skill set to cope when bad times appear in the future.

You can change your life. Things do get better. If I can do it, so can you.

Lisa

18 months ago I started treatment for borderline personality disorder in the form of dialectic behavioural therapy (DBT), under the care of Northants Personality Disorder Hub. It consists of weekly group therapy, as well as weekly 1:1 sessions with a DBT therapist. I didn't want to start group therapy at all; the thought of sitting in a room full of people all sharing experiences and talking about skills and everything else completely overwhelmed me. It was just so daunting knowing that for the next fifteen months, I was going to have to come here every Thursday and sit uncomfortably for two and a half hours, and at the time I had little faith that whatever they taught me would work.

I was adamant for a long time that I didn't want to form any kind of relationship with my fellow group members; I didn't want to care about them nor did they care about me. I was closed off and shut down and it took me a long time to realise that actually, these people can help me. These people understand what it's like to suffer like I have. Once I had realised that, I opened up and let them in. The single best thing I have done in my life.

It has been my experience that learning DBT skills comes in waves, much like emotions. At first, the overwhelming feeling of fear and the unknown makes it difficult to take in any of what is said. Then, once you settle in, the motivation to learn kicks in and things seem to click. Things seem to improve somewhat. Then, there's a dip, a blip and things start unravelling again and you think 'Oh no! I'm back where I started. I'm even worse than I was BEFORE!' DON'T PANIC! This is the point where you are facing things head-on, reprocessing your past experiences; you are feeling for the first time in a long time and it's scary. You will relapse. You will think 'What's the point'.....BUT...DON'T GIVE UP!

I believed that this therapy would 'fix me', that I would suddenly transform into the person I always thought I would be, and that I would miraculously erase my life and start again. My journey has taught me that I am not broken, that I AM the person I should have been all along, and that my experiences have made me resilient, compassionate, strong-minded, loving, passionate and damn right determined. My personality is not disordered, my life is. I am the product of my environment and I am not inherently bad.

Another major misconception I had was that the skills would make me feel better. They won't. Sometimes they make you feel worse! But, it is not about eradicating feeling; it is about learning that you can feel and survive and that the things you do feel do not last forever; we are not static.

Most of the skills in DBT make logical sense. There were times I would sit in the group and listen to the facilitators and think 'This is just common sense!' and get annoyed because I believed they were trying to teach me things I already knew (because I am adamant that I know everything and am never wrong!!). Trying to implement these seemingly 'simple' things into your day-to-day life is a lot more difficult than I anticipated. Trying to access these skills amidst a crisis is sometimes impossible!

The one skill I continually struggle with is radical acceptance. Why would accepting things make any difference whatsoever to my life now? I still don't really have the answers to this, but one thing I am trying to get my head around is that accepting something as it is DOES NOT MEAN that you agree Review date: October 2023 with it. In the words of Albus Dumbledore, 'Understanding is the first step to acceptance, and only with acceptance can there be recovery'.

The module I have found most helpful is distress tolerance. It has taken a lot of effort to learn how to self-soothe. The hardest part is choosing to soothe myself over self-harm and punishment. However, my journey of discovering what self-soothe means to me has been interesting and I'm still learning more about myself. I've learned that I respond well to most sensory stimuli, mostly smell and touch and it has helped me connect to the little girl inside me and try to find comfort in my environment. Self-soothe has allowed me to regress; it's the one time I can be a child, and it's OK. I'm learning to care about myself, and that feels very odd.

15 months in the skills group was both the hardest and the best time in my life. It was there that I found the understanding and belonging that I had lacked all along; I found a family. I have made one particular friend from the group; someone who I connect with and whom I love unconditionally; we are inseparable. Together we are continuing to make a life worth living...in our very own flat!

I think it will always be a constant battle to quiet my mind and the thoughts that condemn me. I'm OK with that. My time with my 1:1 therapist, Sue, has taught me oceans. I've learnt that I don't have to be perfect; that I am perfectly imperfect and that's just fine. I've come to realise that I have been through a hell of a lot and I need to give myself credit for just being alive; that I am a survivor, NOT a victim. I am eccentric and that's part of my charm; I'm not crazy at all! I am the queen of catastrophising, but I am getting better at noticing that and trying to rein my thoughts in. I am an artist, and with that comes (great responsibility) creativity, emotion, an insane imagination, empathy and exuberance (which apparently is contagious). I deserve to be loved and I am loveable; I am NOT damaged goods. I still suck at being mindful, but like I said, I'm not perfect! I'm learning that I am not out of sight, out of mind, that I am always connected, by the moon and the stars, and that I am always held in mind; not forgotten. Most of all, I have learnt to trust. I think the thing I will hold on to most from my time with Sue is one particular text message 'Remember to soothe, don't hurt'. I have it tattooed on my hip so that it will be a constant reminder of the path I should be choosing, a reminder to take care of myself, love and comfort myself, not destroy my soul. Thank You, Sue. For everything.

When I compare myself now to how I was then, the changes are slight, but significant. My self-harm has gone down dramatically, from every day to rarely, and although I still struggle daily with urges to self-harm, I have control now, and most of the time, I make the right choice not to act.

I used to be completely isolated and shut off from the world because I was scared of it. I am still scared of it, but I'm in it. I'm trying to feel the fear and do it anyway!

The Hub has helped me change my life. I'm still a work in progress and I am realistic enough to expect the peaks and troughs of recovery, but you guys have helped me find my fight again. For the first time in my life, I know who I am, and who I am isn't all that bad. My DBT experience has been a roller-coaster and I have very mixed emotions about leaving. At the start, I didn't want to do it, but at the end, I would do it again in a heartbeat. It's not just the skills I have learnt, I have learnt more about myself and others than I thought possible. Most of all, I have learnt my own value; I am priceless. 

Cherie 

My experience with the Northants Personality Disorders Hub has been one of the most VERY inspirational - life-changing times. Before I was assessed to be part of the Hub, my life was disastrous - I'd been sectioned at least three times (which was really horrible), but at this point in life, anger and suicide were the only emotions I was able to feel, but at this time I was very impulsive, which didn't help at all.

When I was accepted to the Hub, I had a three-month support of 1-1 with Sue to see what the main areas of my life needed improving. Sue was a very inspiring, empathetic, kind-hearted person, who I felt happy to share my issues with. Anger was the main issue. I needed help changing in my life.

When I started the group, I was very anxious, but I found it helpful to be around others with similar lifestyle experiences as we understood each other well. I used to want to give up all the time as I didn't understand it at all, but I started asking lots of questions and this surely did improve my knowledge. Whenever I needed help outside of the group, phone calls and 1-1 sessions were my key to the door.

When I did my midway assessment, my score had dropped, which showed my life was improving. I started working at a school as I'd learned so many skills by now - these were my coping mechanisms.

• Interpersonal effectiveness improved my way of bonding with others, so I held relationships much longer than I could before with friends, family, and professionals too
• Emotional regulation skills helped me recognise, accept and deal with all emotions in a stable way
• Mindfulness helped me learn to bring my mind back to the moment whenever it wandered

By the end my score was so low, which means I don't have borderline personality disorder anymore - YEAH!

Due to all the skills I've learned .. I've become a SPICE girl, which means: Social Skills Physical Skills Intellectual Skills Communication Skills Emotional Skills

These have all helped me believe in myself and also believe that LIFE IS WORTH LIVING.

With a massive thanks to all of the support from all the inspirational staff from the Northants Personality Disorders Hub THEY ARE THE BEST!

Jack

My name is Jack, I'm 28 and I'm from Warwickshire. I grew up in a household with a lot of love from one parent and a lot of neglect and hostility from another.

I was a very flamboyant and extroverted child and got targeted a lot for being gay. I created YouTube videos as a way to express my creativity and the kids at school soon discovered them. I was relentlessly bullied all through my adolescence. I had friends who turned their back on me when the bullying got extreme, they didn't want to be associated with me and it was easier to join in on it. It was excruciatingly traumatic to experience that kind of rejection at such a young age.

I suppressed all of this throughout my school years. I struggled with coming to terms with my sexuality as I had been told to be ashamed of it my entire life. When I reached about 17 all that repressed emotion and denial started to manifest in depression and self-destructing behaviours including self-harm, drinking and drugs. This was a frequent occurrence into my early twenties.

I eventually found happiness coming out of the closet and discovering who I was but I still struggled with emotional regulation, suicidal thoughts and anxiety. I was in and out of hospital for suicide attempts when the stresses of university increased or the anniversary of a break-up would come around.

I always felt so isolated growing up in a small town and never really felt like anyone understood me. It was really hard having no sense of community as a young gay person. For the longest time, I was convinced I was destined to be unhappy forever. I had made peace with the fact that suicide could quite potentially be how I go. When things got to their worst I finally got in contact with the Personality Hub.

I started DBT therapy which was my last chance of trying to get better. I had done multiple forms of therapy over the years with all kinds of different people but it was always putting a plaster on the issues. I would feel better temporarily but I hadn't worked through the deep-rooted traumas. I had lost a lot of hope for that reason. But DBT allowed me to express all those areas of hurt I could never express or talk about without feeling overwhelming emotional distress.

It was incredibly validating to have someone listen and talk through those experiences with me. I was very willful when it came to learning skills as I wasn't sure they would work but as I progressed through DBT I would notice small little changes. I learnt how to feel, label and work through difficult emotions. I learnt how to accept what had happened to me wasn't fair but to continue reliving it was only re-traumatizing myself.

I learnt different ways to communicate with the ones I loved around me. I learnt healthier ways of coping when I would be climbing the emotional escalator. Slowly but surely I found a way to create a life worth living.

I found out how to navigate my passions and form a sense of community in my unique ways with certain loved ones. Joining the DBT group was a huge thing for me because I finally met people that I could relate to when it came to my illness. I no longer felt so alone in my suffering or experiences. I could embrace all the different parts of myself and celebrate them in a way I had never before. DBT was a long journey but it was seriously worth it.

Sometimes it felt like you were back to square one when having a bad day. But every time upon reflection you look at those small changes which are actually huge changes. You start to realise you are actually coping more than your past self could ever have imagined.

It is without a doubt the reason why I'm sat here writing this today.

It saved my life when I lived in a world I didn't think I would survive.

Emery

Before I began DBT and prolonged exposure treatment in Northampton I had very little belief and trust in mental health services after being under various teams in the UK for ten years. I felt very hopeless, lost and scared all the time.

I had attempted DBT previously during inpatient admissions, however, this was very basic, and the environment made it very difficult to take on board. Because of this among other previous experiences, I was very sceptical to try DBT again. I was terrified of the idea of group settings and knowing I would need to open up again to a new therapist. The assessment sessions were tough having to re-explain my history, but my therapist and the wider team were extremely patient, even after I briefly quit and decided to come back. They were all non-judgemental and validated why I would find this beginning difficult.

The group sessions can be intimidating initially as there are more established members and a lot of new information to take in, however, everyone was supportive as everyone was new at some point and new in learning the skills and acronyms - including the facilitators. Even though I wasn't always consistent with my homework or chain analysis at the beginning, once I started to reflect more regularly, I noticed my confidence in identifying and using different skills grew a lot as well as noticing my negative thinking patterns which eventually enabled me to stop the patterns much earlier and before they escalated to problem behaviours. I used to think skills like mindfulness were exaggerated with how helpful they can be but now I am the person who tells my friends about how useful it can be.

Once you are halfway through DBT treatment there is the option for prolonged exposure therapy to help manage and process previous traumatic experience(s). At first, I found the idea of being self-harm free for 3+ months to be eligible incredibly daunting, but this ended up being what made me stop and motivated me to remain self-harm free. I did find prolonged exposure tough, but I also did find it to be the most beneficial for me especially in maintaining my recovery. I have noticed listening to the reprocessing part in my recordings the most useful as it challenged the firm self-blame and negative narratives I held about my experiences. However, I did find that was something that kept developing and is still developing even after I had left treatment, so I do still listen to them when possible. Managing memories and flashbacks from those experiences is much easier now than before I completed prolonged exposure and I very rarely now have severe flashbacks.

I spent a long time being made to feel I was untreatable when the reality is that isn't the case for anyone. Both DBT and prolonged exposure are intense, but the payoff is so worth it. I was told that mid-way through my treatment if I put in half-hearted effort, I would get half-hearted results and it was what I needed to hear at the time but still the most important thing I could pass on. You will get out what you put in and that will continue after treatment too. I finished treatment in 2021 and I still use and practice many of the skills I learned and continue to refresh myself if I forget.

Cam and Sophie

Meet Cam and Sophie as they talk about their experiences of DBT therapy while in the care of Northamptonshire Personality Disorder Hub (previously Number 63). 

Kerry and Andy

Two of our experts by experience, Kerry and Andy talk through their experiences of Structured Clinical Management services provided by the Northamptonshire Healthcare NHS Foundation Trust's Personality Disorder Hub.