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    The surviving emotional storms programme : a service user informed programme developed from an exploratory study of help-seeking experiences of NZ tertiary students with Borderline Personality Disorder : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Auckland, New Zealand
    (Massey University, 2023-04-11) Beckett, Jennifer Jean
    In this qualitative thesis, 14 university students were interviewed about their lived experience of having Borderline Personality Disorder. Participants discussed arduous journeys in search of effective treatment and described their increasing risk while trying to access help, alongside their experiences when able to access publicly funded treatment. Results from thematic analysis highlighted a super-theme of a continuous invalidation loop, discussed from an ecological and attachment perspective. This started with early help-seeking invalidation in participants’ microsystems, with the loop then broadening across systems over time, and help seeking attempts. This included contact with the mental health system, which was suggested to be a perpetuating factor in the development and maintenance of Borderline Personality Disorder. The help-seeking invalidation loop was briefly interrupted when participants were diagnosed, which occurred for most, directly after a suicide attempt. Diagnosis brought temporary relief, when participants armed themselves with knowledge about the condition including prognosis and treatment. The validation from informed diagnosis aided an externalisation process to occur, enhancing connections with self and others. However, accessing treatment proved difficult, crisis and respite was perceived as invalidating and when in treatment participants’ attempts at connection were often thwarted. Results from the thematic analysis guided the design and delivery of a group intervention. The intervention was administered using an action research methodology to university students either diagnosed with Borderline Personality Disorder or with borderline traits. The intervention, an adaptation from traditional dialectic behavioural therapy, integrated the results from the thematic analysis. To address the super-theme findings, attachment theory was interspersed throughout the intervention, utilizing aspects of narrative and acceptance and commitment therapies. The intervention was adapted and evolved from participant feedback over six cycles of 12-session intervention groups. In each group participants reported reduced severity of borderline symptoms and increased mindfulness ability. The research took place prior to and during the global pandemic and Covid-19 mandatory lockdowns in NZ, during which the research was expanded to finish with an online intervention accessed by students across NZ.
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    Dialectical Behaviour Therapy skills use in a Substance Use Disorder and Borderline Personality Trait population : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology
    (Massey University, 2012) Howard, Victoria,
    This study examined the skills used within a Dialectical Behaviour Therapy programme for 13 clients presenting with comorbid Substance Use Disorders and Borderline Personality Disorder traits at the Community Alcohol and Drugs Service North. This was the first known study to evaluate skills use within a 12-month Dialectical Behaviour Therapy programme for this client population in an outpatient alcohol and drug community based treatment service in New Zealand. Dialectical Behaviour Therapy is an evidence-based treatment comprised of four components, one being the training and practice of behavioural skills. Skills training has been suggested as an important element in attaining positive treatment outcomes. This study was designed to explore the frequency and variety of skills used by clients in this population. Skills use was recorded on the daily diary cards completed by clients over the course of treatment. The findings indicated that the clients made statistically significant increases in their rate of skills use as treatment progresses. Increases in all skills modules were observed, with the skills module of Core Mindfulness being used the most frequently, followed by Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. In addition, findings also indicated reductions in substance use and substance use urges. These findings suggest tentative support for the use of Dialectical Behaviour Therapy skills training with Substance Use Disorder and Borderline Personality Disorder trait clients in an alcohol and drug community based setting.