Background Treatment non-completion is a signifi cant problem for personality disorder treatment services. Aims We investigated differences between treatment continuers and treatment discontinuers of a tertiary specialist service for people with borderline personality disorder. The two groups were compared on: (1) personality disorder severity; (2) motivation for therapy; (3) mood; and (4) social problem solving. Method Patients' personality disorders were examined using the International Personality Disorder Examination. Three self-report questionnaires were administered at the start of treatment: the Treatment Motivation Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Social Problem Solving Inventory-Revised. Results Of 14 outpatients recruited to the service during 2005 to 2007, seven continued and seven discontinued treatment. Those who did not continue with therapy had more complex personality disorder profi les, were more externally motivated for treatment and were less internally motivated for treatment. All patients scored high on the HADS. Problem-solving abilities were apparently intact, but adversely affected by a negative problem orientation. Treatment discontinuers spent, on average, three times longer in hospital than continuers. Conclusion Engaging people with complex personality disorders, low internal motivation for therapy and negative problem orientation is a challenge for services. Non-completion of treatment is associated with more days in hospital and higher service costs.

Background A relationship between emotional intelligence (EI) and borderline personality disorder (BPD) has recently been identifi ed. EI has also been found to overlap considerably with alexithymia, a construct associated with emotion processing and emotion regulation. EI and alexithymia may further our understanding of the relationship between emotion processing, emotion regulation and BPD. Aims We examined the relationships between EI, alexithymia and BPD traits, hypothesizing that EI and alexithymia would correlate negatively with each other, that EI would correlate negatively with BPD traits and that alexithymia would correlate positively with BPD traits. We also hypothesized that low EI and high alexithymia would predict BPD traits. Method A sample of 134 male and female university students completed the Bar-On Emotional Quotient Inventory: Short (EQ-i:S), the Toronto Alexithymia Scale and the Personality Assessment Inventory-Borderline Scale (PAI-BOR). Relationships were examined using correlation and multiple regression. Results The EQ-i:S and the TAS-20 correlated moderately with each other. None of the EQ-i:S scales predicted PAI-BOR. The TAS-20 total signifi cantly predicted PAI-BOR. Conclusions The relationship between alexithymia and BPD suggest that diffi culty identifying, differentiating, understanding and communicating emotions and feelings (somatic sensations) impairs ability to regulate emotions. It may be that an inability to discriminate emotions and somatic sensations explains why people with BPD who are distressed use deliberate self-harm as a means to emotion regulation.

Background Department of Health guidelines stipulate that specialist personality disorder services should gather feedback from service users.Aim The Gwylfa Therapy Service (GTS) is a new specialist service for people with borderline personality disorder (BPD). The aim of this study was to gather users' views of services sought and/or received before the inception of the GTS and their views of the GTS.Method A Delphi survey method was used first to elicit patients' views on services, and then to identify levels of consensus on the views generated.Results The findings presented here identify what service users value in the treatment they receive, namely respect, professionalism, a service that meets their needs and personal support. Opinions regarding non‐specialist services indicated that, overall, police, general practitioners, community psychiatric nurses, psychologists and counsellors were viewed positively, and psychiatric hospital staff was viewed positively but with room for improvement. General hospital staff was viewed unfavourably. Users' views of the GTS were favourable.Discussion This study begins to shed light upon the education, training and supervision needs of staff from services that come into contact with patients with BPD. Furthermore, the way these services may be better integrated with each other and GTS is identified as requiring attention. Care must be taken to avoid distressing, damaging and disaffecting patients as they pass through general services en route to a specialist team. Copyright © 2008 John Wiley & Sons, Ltd.

Purpose Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services. It has been gradually adopted as the risk evaluation and safety-planning technique for all seven health boards in Wales. The purpose of this paper is to examine the opinions of WARRN as used within these health boards. Design/methodology/approach An online survey was disseminated to NHS clinicians in secondary mental health services to evaluate their perceptions of the use and effectiveness of WARRN. Data from 486 clinicians were analysed with both quantitative and qualitative methods. Findings Results indicated that the overall impact of WARRN on secondary mental health care was very positive, with clinicians reporting increased skills in the domains of clinical risk formulation, safety-planning and communication, as well as increased confidence in their skills and abilities in these areas. Clinicians also reported that the “common-language” created by having all NHS health boards in Wales using the same risk assessment process facilitated the communication of safety-planning. Crucially, NHS staff believed that the safety of service users and of the general public had increased due to the adoption of WARRN in their health board and many believed that lives had been saved as a result. Originality/value WARRN is perceived to have improved clinical skills in risk assessment and safety-planning across Wales and saved lives.