Chair: Karen Bailey (Secretary Australian BPD Foundation)
a) NATIONAL TRAINING STRATEGY: OVERVIEW AND STAGE 1 presented by Rita Brown
The Ministerial Expert Borderline Personality Disorder Reference Group in 2010 – 2012, as articulated in the NHMRC Clinical Practice Guidelines for the Management of Borderline Personality Disorder (BPD), identified a clear need to provide people with a lived experience of BPD with access to high quality, responsive, evidence-based treatment, care and support.
The Australian BPD Foundation, in partnership with peak personality disorder organisations, developed a four stage National Training and Professional Development Strategy: ‘Upskilling and engaging clinicians working with people with borderline personality disorder and their families/friends/kin, to improve mental health practitioners and service providers’ capacity to recognise, respond to, and treat people with BPD, and provide better support to their families and carers.’ The National Mental Health Commission funded this four stage strategy.
Given the national relevance of this training and the importance of reaching diverse audiences across Australia, a mixed delivery model was proposed which incorporated a combination of self-directed online learning, a train the trainer model, and post-training support services.
Stage 1 comprised a series of six webinars and an online virtual library, all of which are still being used by organisations today.
b) NATIONAL TRAINING STRATEGY: STAGE 2 - Brin Grenyer
Introduction: Effective treatment of borderline personality disorder (BPD) is a known challenge for mental health systems. There is a need for readily accessible, evidence based educational tools designed to assist clinicians understand and respond to BPD.
Method: Participants (N = 1824) were mental health workers (social workers [27.5%], nurses [21.1%], psychologists [18.9%], or others [e.g., support worker - 6%, clinicians – 6%, peer worker – 2%]) who completed a five-module training program developed by Project Air Strategy for the Australian BPD Foundation and National Mental Health Commission on effective treatment for borderline personality disorder. Participants were predominately female (84.2%), mean age 36.4 years (SD = 11.8).
Results: Over 90% of participants reported being either ‘satisfied’ or ‘very satisfied’ and finding it ‘helpful’ or ‘very helpful’ for improving outcomes of care. Similarly, almost all participants found it improved their willingness, optimism, theoretical knowledge, enthusiasm, confidence and clinical skills in treating personality disorder, and 98% of participants stated they would recommend the eLearning.
Discussion: Contrary to the belief that training clinicians to effectively treat BPD is necessarily lengthy, expensive and specialised, these results support the usability, relevance and effectiveness of this eLearning to assist clinicians treat BPD.
c) NATIONAL TRAINING STRATEGY - CORE COMPETENCIES FRAMEWORK 1 - Marianne Weddell
Spectrum, in partnership with the Australian BPD Foundation, was responsible for the completion of Stages 3 and 4 of the NTS Project. Evidence-based treatments for personality disorder are often highly specialised, resource heavy, and time intensive. Clinicians often have limited knowledge and capacity to offer these treatment, leading to them feeling ill-equipped to effectively help people with personality disorder. The Core Competencies Framework demonstrates how adopting a common factors approach can make treatment of personality disorder more accessible for clinicians across all sectors of service provision, building their confidence, skills and knowledge for working with people living with BPD and their families.
The 10 modules were taught over two days, utilising a participant manual along with a vignette and a video series to demonstrate skills and principles. To support change in clinical practice, post-training support sessions were offered. A Train the Trainer Program was implemented to extend the reach and longevity of the NTS. This was implemented with an additional two-day workshop focused on the pragmatics of delivering training, ongoing post-training support, and the building of a sustainable community of practice.
d) NATIONAL TRAINING STRATEGY - CORE COMPETENCIES FRAMEWORK 2 - Cathryn Pilcher
In 2021, the two-day Core Competencies training program was rolled out nationally in metropolitan and regional/rural areas. Program attendees represented a wide range of sectors, professional disciplines, and service sectors. Evaluation of the program included pre- and post-training surveys exploring participant attitudes, confidence and skill competence for working with people diagnosed with BPD. Post-evaluation demonstrated improvement across all of these aspects.
Participant feedback was highly positive, with many stating that this training changed the way they approach their work. Upskilling experienced mental health clinicians to become trainers in their own right extended the life of the NTS, improving equity of treatment for people with personality disorder on a national scale.
Since the rollout of the NTS, the Core Competency Framework has been implemented within various sectors including the Victorian Mental Health system, forensic mental health, and adapted for corrections officers, NDIS, NGO, Centrelink, and AOD services.
A service development model was the most effective implementation strategy for the Core Competencies Framework, ensuring that there is (i) a priori organisational commitment and support, (ii) a local ‘champion’ to build a community of practice within and between services, and (iii) investment in post-training support as an integral part of the training package.
e) WORKING TOWARDS A NATIONAL POLICY FOR BORDERLINE PERSONALITY DISORDER - Rita Brown
Despite the clear prevalence and serious harms associated with BPD, Australian medical and mental health systems lag behind international best practice in adopting policies and practices that will effectively meet the needs of people with BPD.
The Australian BPD Foundation (representing carers, consumers and clinicians) determined that the development of a National Consensus Statement was a key priority in its work towards equitable access for everyone impacted by BPD to appropriate, timely treatments and support. The expectation was that a unifying National Statement would assist stakeholders to develop clearly articulated policies to take forward in their respective academic, service and advocacy roles.
Individuals and organisation representing diverse perspectives including lived experience (consumers and carers/supporters/kin), clinicians (mental health service directors), researchers, and academics in the personality disorder field were invited to be a part of the development of the National Consensus Statement by, with, and for people impacted by borderline personality disorder.
This document has become the central pillar informing the Foundation’s advocacy, with over 20 organisations offering their support and hundreds of individuals providing online signatures.