Knightstone Ward – Highly Specialised Personality Disorder Service

Knightstone Ward is a 16 bed highly specialised personality disorder service. The service provides a behavioural approach and a fully comprehensive Dialectical Behaviour Therapy (DBT) programme focused on generalisation of skills. The service is for individuals with a primary diagnosis of personality disorder and a secondary diagnosis of disordered eating or autism. All aspects can be treated simultaneously at Cygnet Hospital Kewstoke, with the appropriate specialist therapeutic input provided.

All members of the multidisciplinary team are extensively trained in DBT, this includes members of the nursing team being DBT therapists or DBT essentials trained. The team comprise of a ward manager, consultant psychiatrist, psychologist, occupational therapist, support workers and social workers.

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Collaborative working is an essential part of Knightstone Ward not only with external professionals but also carers having the option to contact the responsible clinician or ward manager and to attend meetings, where appropriate.

“This service has been a large help to me everyone is very supportive.”Service user, Knightstone Ward

Our three stage comprehensive DBT programme:

  1. Pre-engagement – this involves crisis management and basic DBT skills awareness which allows the multidisciplinary team to aid the service users in developing ‘a life worth living’. An initial assessment will take place after four weeks by a member of the psychology team to assess suitability for stage 2. Bluebell, a five bed area within Knightstone, is where these service users are supported.
  2. Engagement – this is the process of the service user engaging in the DBT programme, this includes two group sessions per week and one 1:1 session per week with their allocated therapist.
  3. Graduation from DBT – moving towards supporting transition to the discharge setting identified in the CPA meetings.

The length of stay on Knightstone Ward can be varied depending on the pathway agreed for admission. The pre-engagement process is of a period of three months and stage 2, to start the DBT programme, is nine months.

“The support here is incredible and they are very recovery focused.”Service user, Knightstone Ward

We also offer a transitional pathway for our service users to Cygnet Lodge Kewstoke. This allows the women to move towards community integration. All service users on this pathway are over seen by the same responsible clinician and psychologist to provide continuity of care.

Our service user profile:

  • Women, aged 18+
  • Primary diagnosis of emotionally unstable personality disorder (other personality disorder types will be considered)
  • Requiring assessment and treatment in a secure environment
  • Secondary diagnosis of disordered eating or autism
  • May present with co-morbid presentations:
    • Self-harm
    • Self-neglect
    • History of substance abuse
    • Complex needs
  • May have a history of trauma and/or abuse
  • May have experienced previous placement breakdowns
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