Spectrum Principles of Treatment

Staff at Spectrum strive to develop respectful and collaborative relationships with clients and with services involved. Spectrum staff are open to a variety of theories, views, methods and styles of treatment. We have a strong commitment to finding the wisdom in apparently divergent views and to fostering a climate of open enquiry in which both clinicians and client can be supported in reflecting on and learning from their own experience.

When working with people with personality disorder, Spectrum considers the following principles important:

Right to Treatment

Clients have a right to equitable access to therapeutic treatment and support services.

A Developmental Understanding
The approach to treatment is based on an acknowledgement of early childhood experiences, including in many cases, the effects of trauma and deprivation. It is also based on the recognition that difficulties with emotions and relationships lie at the heart of the disorder.

Relationship Based Treatment
Therapeutic relationships with the treating staff are central to the process of change. We acknowledge that developing and maintaining the kind of relationship that will make effective treatment possible is likely to be difficult and the clients past experiences of negative relationships will initially pose many difficulties.

Learning from Experience
Staff need to take responsibility for the inevitable conflicts that arise among them when complex issues occur. Mistakes will sometimes be made and the exploration and repair of these is a crucial part of treatment. Patience, a non-blaming stance and the recognition that staff and patients are doing the best they can, are essential.

Valuing Different Perspectives
There are several theoretical models and treatment approaches for BPD that are backed by research. No one of these has been found to be the only answer. All require considerable training and support for staff attempting to implement them. We take the view that it is important for treating staff to have a shared and coherent approach. As no one model has been found to be superior, we don't recommend one approach over another. Many apparently divergent approaches have common features, or related techniques for addressing core issues.

Empathy and Empowerment
All major approaches emphasise the importance of listening, empathy and validating the individual's experience. There is also general agreement on the importance of empowerment and leaving responsibility in the hands of the client, while working with self-harm, suicidality and other crises. Another area of agreement is the need for staff to help people to deal with potentially overwhelming emotion.

Patients and staff are supported to take responsibility for themselves and their actions. At all times patients are supported to take up autonomous positions.

Long term Perspective
Treatment is generally long term and requires thoughtful anticipatory planning for transitions, crises and disruptions.

Service co-ordination and collaboration
Due to the complexity of the work, there is a need for a well co-ordinated, integrated, appropriately supported service system response. Often more than one worker and more than one type of service is needed to address the individual's needs. Effective treatment requires ongoing, active collaboration of the client in the treatment planning and review.

Staff Support and Supervision
As the work can be complex and emotionally demanding it is essential that the organisation provide strong backing for the staff doing the work. This includes a clear mandate for the work including support and training. Essentially, supervision needs to be provided that is not line management, but a space to reflect on the client/clinician interaction.