COT Pearson Award winner champions a ‘do with’ culture to improve outcomes for patients with personality disorders

Image credit: Christof Van Der Walt

Keir Harding was the recipient of this year’s COT Pearson Award for education, research or continuing professional development, an award which funded Keir’s attendance at the British and Irish Group for Study of Personality Disorders annual conference (BIGSPD). Here, Keir talks about applying for this award and the impact that ‘healing through doing’ can have on an individual's life.

Receiving the Pearson award was a fantastic occasion for me. Five of us had applied to present at the British and Irish Group for the Study of Personality Disorder annual conference on the Isle of Man. We were so proud when our abstract was accepted but as time drew on it became apparent that there was no money for any of us to go.

Desperate to find any way to make our presentation happen I found the Pearson award on the COT website and spent an hour filling the form in. To find out that I’d be receiving the award, that our presentation would go ahead and that I wouldn’t have to phone the organisers sheepishly telling them we were withdrawing was a massive relief. It did come with the anxiety that I would now have to do a 90-minute, 5-man presentation on my own.

Talking about Ymlaen

The conference was coproduced with service users and it was wonderful to be in an environment where the lived experience of personality disorder was valued as much as its academic study. I went to the conference to talk about Ymlaen, the day therapeutic community we run in Cardiff.

Most therapies have an expert who dispenses their wisdom to someone who is seeking change. People with personality disorder frequently struggle with traditional therapies because the people who should have cared for them abandoned, neglected or violated them. How do you trust people who are supposed to help after that?

Ymlaen takes away the carer/cared for dynamic. We see the service users as the experts in their difficulties and so they make all the decisions in the group. We vote on all our decisions and as the staff are outnumbered by the group members, it is they who hold the power.

Belonging and acceptance

The group is owned by the members with each of them being elected into roles that allow the day to function. These roles range from greeting new members to chairing the meetings. It’s wonderful to see people who couldn’t speak when they first came later telling the staff to stop talking. Because members are chosen and supported by their peers, they feel an incredible sense of belonging and acceptance. Because they feel so supported, they are able to hear and act on stark feedback from their peers which would be unacceptable if staff said it. We have seen people leaving abusive relationships, go record times without self-harming and massively reduce their inpatient admissions.

I went to BIGSPD to talk about the evidence base for this type of intervention, how we managed to get it set up, what the staff do in the service and our results so far. People were particularly interested in how we had persuaded an organisation that focused on protocols and set ways of doing things to support a group where our response to every situation was “we will talk about it and decide”.

For me, this way of working is one of the purest examples of People Healing Through Doing in healthcare and I would love more OTs to get involved.

In the end I got great feedback from the presentation with people saying that they were going to try to implement similar services in their areas. I also got to meet with some of the leading names in the field of personality disorder and spend a lot of time networking with like-minded people.

I thoroughly enjoyed my experience at the conference and I hope I was able to persuade others that the work I’ve been doing was valuable and 'doable' in their own organisations. Some unexpected bonuses from the conference were that I finally got my head around Twitter and set up a professional profile, and I learned (In an excruciatingly painful way) how to add audio to PowerPoints. Without the Pearson award I’d have missed some great opportunities; that hour filling in the application for might have been one of my most productive ever.

by Keir Harding

About the author

Keir Harding qualified as an OT in 1999 and has always worked in mental health. Over the past years he has specialised in the field of personality disorder, winning an NHS Wales Award in 2012. For the past 4 years Keir has worked in Cynnwys (together), the personality disorder service in Cardiff, where he has championed service user involvement and therapies that 'do with' rather than 'do to' people. As part of his role he set up Ymlaen (forward), a day therapeutic community which works radically differently to traditional mental health services. Keir is currently completing his MSc in Personality disorder.