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A complex mental health issue that emerges in early adulthood is borderline personality disorder (BPD). It is a personality disorder classified by ongoing behavioural issues and feelings that cause decreased functioning and increased distress over time. BPD affects 1-3% of the population and has a lifetime prevalence of 5.9%.
CHN, ACT’s PHN, commissioned the University of Canberra (UC) to develop and implement a program that focuses on early intervention for mood regulation in emerging adults (aged 15-21 years) at high risk of BPD. UC conducted the intervention program, named WOKE, that utilises dialectical behavioural therapy (DBT) performed by student clinicians, under the supervision of skilled psychologists. This program teaches clients and their family and/or their supports, skills and techniques which can then be effectively adapted to their environment to assist with reducing psychological distress and which are transferrable through all areas of an individual’s life.
Over the last year, UC delivered 940 sessions (207 more than the previous financial year), of which 331 were group sessions and 480 individual sessions. They also implemented an enhanced focus on family involvement in response to parent feedback from previous programs, which saw the addition of 2 parent-only group sessions. The newly introduced parent-only group sessions worked on increasing understanding of the difficulties young people face and how to use behavioural principles to support change. In addition, evaluation components were added to determine the impact on families of the enhancements. The greater emphasis on family engagement saw 17 families also engage with individual treatment sessions, and 52 family sessions being run in program 8.
Client story
Jessica* (not her real name) was referred to the WOKE program for assistance managing emotion dysregulation and suicidal behaviour, including impulsive non-suicidal self-injury, suicidal ideation and suicidal urges. These difficulties were impacting her academic performance and her interpersonal relationships with peers and at home. Jessica’s pattern included difficulties managing intense emotions such as anger, anxiety, shame, sadness and loneliness, leading to risky impulsive behaviour. Jessica described an increase in impulsive behaviours, such as engaging in conflict with family members and peers (e.g. yelling, screaming, angrily lashing out), self-harm by punching self, cutting or ‘clawing’ at forearms, and suicidal behaviour including hospitalisation for an overdose. At the completion of the WOKE program, Jessica had stabilised and made significant progress. Life-threatening behaviours including non-suicidal self-injury, suicidal ideation and suicidal urges were no longer pervasive and her capacity to regulate her emotions had improved. Jessica reported ‘feeling better’ and cited the increased use of the DBT skills such as self-validation and self-soothing as being instrumental in helping her. She also reported being able to seek support more effectively because of her learning the interpersonal effectiveness skills. Jessica had a positive experience with her therapist and indicated that she was feeling much more stable and ready to benefit from psychological treatment after WOKE.
