Quantitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder.

BACKGROUND: Quantitative findings are presented from a mixed methods study of four one-day-a-week therapeutic communities for people with personality disorder (qualitative findings from the same study are reported in a separate paper). The evaluation assessed both the clinical efficacy of the model and its acceptability to service users, service employees and those who refer clients to the services. AIMS: The study aimed to clarify whether one-day therapeutic communities can be effective for people with personality disorder. METHOD: Changes in the functioning of service users who attended the day services were assessed every 12 weeks for up to 1 year. RESULTS: We found significant improvements in both the mental health and social functioning of service users. Changes in patterns of self-harm and service use were suggestive of possible underlying improvements but failed to reach significance levels. We also found evidence of the possible offset of costs within 16 months of an individual leaving one of the services. CONCLUSIONS: This study suggests one-day therapeutic communities may be both clinically- and cost-effective for people with personality disorder.

Qualitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder.

BACKGROUND: This paper presents qualitative findings from a mixed methods study of four one-day-a-week therapeutic communities (TCs) in the north of England for people with personality disorder. Quantitative findings from the study are presented separately. AIMS: The study aimed to ascertain whether one-day-a-week TCs can be effective in addressing the problems associated with personality disorder. METHOD: The qualitative component of the study comprised semi-structured interviews with service users, service user consultants, staff and referrers. This paper reports findings from the interviews with service users. FINDINGS: The qualitative findings indicate underlying changes in thinking that may account for some of the measurable changes in members' mental health and functioning reported in the quantitative findings. In particular, the services enable individuals to address two main problem areas: relating to others and self-harm. CONCLUSIONS: The study suggests that once-weekly TCs provide an effective therapeutic approach to the problems associated with personality disorder.