Electronic Letters to:
|
|
eLetters: Electronic letters published:
-
![[Read eLetter]](/icons/misc/sectionDOWN.gif)
Personality disorder (PD) in older adults: a pilot treatment model.
- Lisle MA Scott, Elizabeth Kemp (23 July 2008)
|
|
|||
|
Lisle MA Scott, Psychiatrist Oxfordshire Complex Needs Service, Elizabeth Kemp
Send letter to journal:
Lisle.Scott{at}obmh.nhs.uk Lisle MA Scott, et al.
|
We agree with the authors’ view that PD does not ‘burn out’ with advancing age, that treatment options are limited and that more research into this area of psychiatry is needed given that the UK has an ageing population. Department of Health publications, No Longer a Diagnosis of Exclusion and the National Service Framework for Older People specifically target equity of access to integrated mental health services for people with personality disorder and those over 65 respectively. In addition NICE guidelines for the management of borderline personality disorder clearly support provision of integrated mental health care utilising a multi-model approach to psychotherapy interventions. We have embraced these recommendations in a pilot service for older adults diagnosable with personality disorder. The service comprises a half -day integrative psychotherapy group programme which adheres to a democratic mini-therapeutic community (TC) model. (Haig & Pearce 2008) The group is facilitated by a multi-disciplinary team embedded collaboratively within the local specialist services for adults of working age with complex needs-Oxfordshire Complex Needs Service (OCNS), psychological services and a CMHT for older adults. Psychodramatic techniques are used to integrate psychodynamic, cognitive and behavioural models alongside principles of biologic psychiatry into a coherent model which is responsive to individual needs. The experience of the facilitators who work in similar groups across both age ranges suggests that the various categories of personality disorder encountered in both groups are similar and that both groups respond to the therapeutic model and process in a similar manner. The OCNS treatment ethos for adults of working age is based on a recovery model and preliminary outcome audit results demonstrate psychological and socio-economic benefits following an 18 month treatment programme similar to the pilot for older adults. (Scott & Attwood 2008) There are no apparent reasons why the outcome results from the OCNS mini-TC programme should not be replicated in the older adult service. Early indications from the Social Function Questionnaire (SFQ), CORE, medication audits and client satisfaction data from this pilot group are similarly optimistic. The service is committed to further evaluation and research to demonstrate effectiveness of this model over time. This pilot programme is unique in the UK and is currently being expanded across Oxfordshire to provide a more comprehensive model of inclusive service delivery to a group of service users traditionally excluded by virtue of diagnosis and age. References: Pearce, S. and Haigh, R. (2008): Mini therapeutic communities – a new development in the United Kingdom. Therapeutic Communities: The International Journal for Therapeutic and Supportive Organizations. Volume 29, Issue 2. (In Press) Scott, L. and Attwood, G. (2008): Integrative psychotherapeutic group work: a way forward in the treatment of personality disorders. Quarterly Journal of Mental Health. Volume 1, Issue 4. (In press) |
|||