Rep36 Understanding Personality Disorder

particular fears. The treatment models have
been more diverse within general mental health
settings, reflecting the more diverse and
individual treatment outcomes, with
psychodynamic, cognitive and behavioural
treatments regularly used. The therapeutic skills
used in both environments could be of benefit to
both. Forensic services could benefit from a
more individual approach and general mental
health services could benefit from targeting
specific behaviours, such as anger, sexual
exploitation and self-harm. There is a need for
regular and consistent communication between
psychologists within these services to share ideas
and expertise with the aim of developing more
coherent and client-focused approaches to
treating the internal, cognitive and emotional,
and the external, behavioural, aspects of
personality disorders.
4.7
Personality disorders across the life cycle
Individuals with personality disorder have
experienced multiple difficulties encompassing
aspects of their biological, psychological and
social functioning. They are likely to have
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experienced adverse childhood events including
disruptions to their attachments, trauma, death
of a parent, and so on, and to have difficulties
integrating with their peers both as adults and
children. Their problems are likely to be long
term and cyclical leading to chronic and/or
repeated presentations to agencies throughout
their lives. These individuals are likely to come
into contact with many health, social care,
voluntary, or criminal justice agencies. In order to
provide effective interventions for these
individuals, it is necessary to consider an all-
embracing approach to identifying the potential
for personality disorders and acting to promote
positive change at the earliest opportunity. This
would require good communication between
education, health and social services for children.
Children identified as at risk of developing a
personality disorder would need to access early
intervention services, which could include family
based interventions to help parents rectify any
difficulties with their parenting that may be
exacerbating the situation. This approach would
be consistent with recent changes to the children
at risk services (Department of Health, 2004).
There is also a need to provide a seamless
transition between services that meet the needs
of the client at each stage in their lives, moving
through services for children to adolescent
services to adult services to services for older
adults. Many of these services exist within current
service provision but do not routinely
communicate. Communication has been a long-
term problem in health and social care (Laming,
2003). There is no simple solution to this
problem but specialist personality disorder teams
providing input across the life cycle could act as a
central point of contact for all agencies and
promote multi-agency treatment as the norm for
this client group.