Stress, burnout and the attitudes and experiences of mental health professionals working with clients who meet the criteria for a diagnosis of personality disorder
The validity and use of the term personality disorder (PID), its sub-categories, and the treatment of those who may attract this type of diagnosis are controversial issues which have long been the subject of debate. In recent years, the development of a number of new treatment approaches, such as dialectical behaviour therapy for borderline personality disorder (BPD) have increased optimism and interest in this group of clients amongst the mental health community. However, despite this increased optimism, much of the research shows that the PID client group is perceived as difficult and stressful to work with. This thesis begins by reviewing the efficacy of psychological approaches to treatment for BPD (Chapter 1). Chapter 2 then explores the relationships between levels of stress, burnout and attitudes towards the PID client group amongst a group of forty mental health professionals working with this group. This study identified that lower levels of personal accomplishment and higher levels of stress at work were associated with a more negative attitude towards the PID client group. The provision of specialist training for work with this group is hypothesised as an important mediator of attitudes. The second empirical paper (Chapter 3) used Interpretative Phenomenological analysis (IPA) to conduct a qualitative analysis of the experiences of four mental health professionals working with clients with BPD. Work with this client group was experienced as complex, demanding and emotionally and physically draining at times. The negative effects of this work appeared to be buffered by gaining formal and informal support from others, development of realistic expectations of the likely progress of client work and strong personal motivations for work with this group. Methodological issues arising from the research and the clinical implications of the findings are discussed. A reflective review of the research processis also provided (Chapter 4).