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    Exploring the past, present, and future of training for staff working with individuals diagnosed with borderline personality disorder

    Shah, Aashni Himanshu (2023) Exploring the past, present, and future of training for staff working with individuals diagnosed with borderline personality disorder. Doctoral thesis (Degree of Professional Doctorate), Manchester Metropolitan University.

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    Abstract

    Background Mental health professionals have reported that they often lack the knowledge and skills to work with individuals diagnosed with borderline personality disorder. Hence, it is crucial to provide BPD-specific training, so service users receive optimal care from competent professionals. However, a range of training programmes is available with no evidence about their components. It is necessary, at first, to determine staff training needs, which can form the basis for training development and ensure it is appropriately targeted. Aim The thesis had two aims. The first was to understand the training needs of mental health professionals working with individuals diagnosed with borderline personality disorder and to identify effective training components. The second was to reflect and discuss the role of nonverbal cues in qualitative interviews through videoconferencing to inform other researchers working in this area. Method Three studies were conducted: 1) the scoping review mapped and analysed the components of available training programmes for staff working with individuals diagnosed with BPD from 18 peer-reviewed journal articles using Framework Synthesis, 2) the qualitative study interviewed 17 mental health professionals about their training needs and their perspectives on effective training components and analysed the data using Reflexive Thematic Analysis, 3) the methodological study discussed how non-verbal data could influence online qualitative interviews through examples and researcher reflections from the qualitative study. 5 Findings Scoping review Eleven training components were charted and mapped through the scoping review: type of training, duration, setting, aim, trainer, trainees, materials and teaching methods, content (knowledge, skills, service user perspectives), supervision, challenges for implementation, and evaluation/feedback. Qualitative study The socio-ecological model was used as a framework to categorise staff training needs at a multi-faceted level, which generated the following overarching themes and themes: intrapersonal needs (knowledge-related needs are subjective, understanding is fundamental, skills for working with service users and colleagues), needs at the organisational level (practical arrangements for training, systemic issues that influence training application and sustainability), and needs at the national level (consistency in training nationwide, disciplinespecific areas for training development). During the interviews, participants were asked if they were a training developer how would they design their ideal training; participant responses produced 13 training components. Methodological study It illustrated through examples and researcher reflections how different non-verbal cues (chronemics, kinesics, proxemics, paralinguistics, environmental factors, and physical appearance) could influence online qualitative interviews. Since these play a role in online data collection, researchers must incorporate thinking about the kind of data they wish to collect and analyse during the design phase of the research. If they choose to incorporate nonverbal cues, there are several ways to achieve this by using practical resources such as matrices and software, involving linguists, and practising reflexivity. 6 Conclusion Many training programmes are available for staff working with individuals diagnosed with BPD. However, they need to be reported in more detail as there is insufficient information about their components. Furthermore, service users and staff need to be involved in training development to make it more efficient in practice and to ensure that their needs are reflected in training. Staff training needs are related to knowledge, understanding, and skills embedded within the larger organisational and national context, which needs consideration. It is hoped that the training components reviewed and those produced by participants will provide a reference point for training developers. Lastly, the methodological paper concluded that researchers need a more nuanced understanding of data in online qualitative research, as nonverbal data could influence the interviews.

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