Bowling Ward – Specialist Female Personality Disorder Service

The aim on Bowling Ward is to support service users with highly complex problems to learn how to have good emotional management, to reduce problems with emotional dysregulation and those associated with a diagnosis of emotionally unstable personality disorder.

The service also aims to help people manage their mental health and facilitate recovery. This is a service which delivers evidence based treatment to effectively support women with a significant history of trauma. The ward can support detained and informal service users via individualised risk assessment and management.

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Support

Whilst this is a rehabilitation service, it is highly specialised in terms of the programme it runs. Service users on Bowling Ward have support from the full Multi-disciplinary team (MDT) and all therapy interventions available including occupational therapy, psychology, social workers, advocacy, IMHA services and others. Service users are cared for in a highly structured environment and have a ward therapy programme alongside a personal programme.

“Before I went onto Bowling Ward I was intent on destroying myself, if it wasn’t for DBT I wouldn’t be where I am today”Service user, Bowling Ward

Prior to their first CPA, all service users participate in a comprehensive psychological assessment, this informs the development of an individualised formulation and recommendations for care. In addition to DBT, other evidence-based therapies such as Prolonged Exposure and Eye Movement Desensitisation Reprocessing (EMDR) are also provided for service users wishing to undertake trauma work.

Service users with a history of substance misuse may participate in our specialist treatment programme, informed by Acceptance and Commitment therapy. To find out more click here.

Bowling’s Dialectical Behaviour Therapy programme

Care on Bowling is underpinned by a comprehensive Dialectical Behavioural Therapy (DBT) programme. DBT is has a robust evidence-base for treating problems associated with a diagnosis of Borderline/Emotionally unstable Personality Disorder. Furthermore, DBT is recommended by NICE (2009) for reducing self-harm behaviours.

“Good staff and knowledge of BPD, fantastic OTs, fed well, good structure and routine, likeable staff, a good environment.”Service user, Bowling Ward

A standard cycle of treatment is 12 months. Our programme is fully comprehensive in accord with all 5 modes of evidence-based DBT:

  1. Skills training group – A weekly, 2 hour group teaching self-management skills relating to: Mindfulness; Emotion Regulation; Distress Tolerance; and Interpersonal Effectiveness.
  2. Individual therapy – Service users participate in weekly individual therapy to address insight, motivation and change. Trauma-focussed work is undertaken as appropriate.
  3. Skills coaching – Ward-based skills coaches help service users to utilise DBT skills by offering scheduled and impromptu coaching, on a 24 hour basis. This supports service users to replace maladaptive coping behaviours with safe and skilful strategies.
  4. Structuring the environment – Care on Bowling is structured in ways that support service users’ engagement with DBT and reinforces positive progress.
  5. Therapist consultation – All DBT therapists meet weekly (2 hours) to receive DBT from each other. This helps us to adhere to DBT principles, while cultivating and sustaining compassion and empathy for service users and colleagues.

We monitor and ensure the quality of our programme with a number of initiatives:

  • Monthly consultation and supervision (2 hours) with renowned international DBT expert Dr Heidi Heard
  • Highly trained therapists, using only British Isles DBT training (this is the only UK training provider endorsed by Behavior-Tech)
  • Quarterly Service-user DBT satisfaction surveys
  • Smaller skills groups to support engagement and learning
  • Regular in-house DBT training for Bowling ward staff and skills coaches

Phoenix Suite

Bowling Ward’s Phoenix Suite provides an additional ‘pre-discharge’ step in the care pathway. This environment is suitable for women approaching discharge and preparing for a move to the community. The Phoenix Suite is a 4-bed flat, separated from the other wards within the hospital, with a living area and kitchenette and access to the shared courtyard. This was developed in full consultation with service users and they have full access with their own key fobs to support this step towards self-reliance and independence.

The Phoenix Suite allows service users to practice and maintain the skills achieved during their stay, in a safe and supported environment prior to a full move to community living. Through positive risk-taking and the encouragement of self-management, service users can make the move towards independence whilst remaining within the security of the hospital environment and retaining access to the DBT programme and the support of the Bowling Ward team.

Facilities

Bowling Ward offers a safe and calming environment. Service users can access outdoor space including secure courtyards, a dedicated activities of daily living (ADL) kitchen, and a variety of activity rooms including an art room and an IT classroom. There is also a fully equipped gym.