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An innovative training initiative to raise the awareness of personality disorder and enable more effective working with people with personality disorder who come into contact with the wider multi-agency system has been developed. For the purpose of the training initiative the nationally recognised Knowledge and Understanding Framework (KUF, awareness-level programme) has been employed. An overview of the comprehensive multi-agency training initiative will be outlined with reporting and discussion of the outcome data provided within this paper. The paper aims to discuss these issues.

This paper outlines the development and outcomes of a service evaluation study. The utilised outcome measures were carried out at pre-, post- and three-month follow-up measures. The Personality Disorder-Knowledge Attitude and Skills Questionnaire was utilised on the recommendation of the central team. Additionally a Visual Analogue Scale was developed for the purpose of this study was also employed.

Data findings are positive particularly when comparing pre- and post-results and the pre- and follow-up results. There appears to be an apparent peak in results post-training which could be attributed to the fact that knowledge and understanding is recent and fresh in the delegates mind, however positive results are still reported at follow-up there does appear to be decline in results and durability of the effect when three-month follow-up is compared against the post-training results.

Follow-up was at three months, which is a relatively short-time span post-training it would be of great interest to see in the future if the decline in the three areas continues. If this was followed up and if this pattern continued this could provide us with evidence to support the development of refresher courses. In the future, due to the multi-agency design of this service evaluation, comparisons of the different sectors, agencies and occupations involved, could also be explored further to establish what multi-agency areas the training has had the most effect and impact.

High levels of demand from multi-agencies to receive training in personality disorder is reported. Our findings and experience provide evidence that multi-agencies partners from a variety of professional backgrounds can effectively work in partnership with people with lived experience to effectively deliver the KUF training.

This innovative roll-out of KUF training provides evidence that with a little investment, a comprehensive multi-agency roll-out of KUF is achievable and can provide statistically significant positive results displaying the effectiveness and change brought about via the KUF training.

The originality of this sustainable and low-cost approach to educating the wider system is reported in this paper. This has lead to the strategy receiving national recognition winning a nursing times award in 2011 and a model of innovative practice nationally.

Mental health professionals working with patients with personality disorder are at risk of burnout. Burnout can adversely affect workforce retention and the delivery of high-quality care. The purpose of this paper is to investigate the impact of the three-day Knowledge and Understanding Framework (KUF) awareness-level personality disorder training on burnout, knowledge and attitudes in staff working in mental health settings.

A total of 253 mental health professionals attended the KUF training, delivered through a co-production model (i.e. co-delivered by a mental health professional and service user consultant with lived experience). Questionnaires were administered at pre- and post-training to assess changes in burnout symptoms and understanding, perceived capabilities and emotional reactions concerning personality disorder.

There were improvements in two burnout domains: decreases in emotional exhaustion (p = 0.009) and increases in personal accomplishment (p < 0.001) between pre-and post-training. Significant improvements were found in understanding, perceived capabilities and emotional reactions (p < 0.001).

This evaluation is limited by a lack of a control group and long-term follow-up. Further research is required to investigate the sustainability of reductions in burnout for mental health professionals attending training and supervision structures.

KUF training may contribute to reductions in the high levels of burnout often experienced amongst staff working in mental health settings and could form a part of a broader strategy focussing on continued supervision and opportunities to integrate learning into practice.

The purpose of this paper is to evaluate the impact of knowledge and understanding framework (KUF) awareness-level training with mental health staff in a UK NHS Mental Health Trust.

In total, 181 mental health professionals completed three day KUF awareness-level training to promote understanding and positive attitudes in working with personality disorder (PD). Attitudes to PD were evaluated using the PD – Knowledge and Skills Questionnaire (Bolton et al., 2010) at pre and post training and at three and six months follow up. Quantitative data were analysed and descriptive statistics were obtained. Qualitative methods were also used to evaluate the integration of learning into work-based practice with five participants.

Participants reported a favourable reaction to the training. Understanding and positive emotions about working with PD increased significantly post training (gains maintained at three and six months follow up). Capability in working with PD was increased post training and at three, but not six months. Qualitative analysis suggests clinical practice was positively impacted upon three months following training.

This research suggests awareness-level KUF training can have a positive impact on the attitudes, understanding and clinical practice of mental health practitioners towards people with a PD. It confirms earlier research on a decrease in capability post training, and explores strategies to further develop capability with this client group.

Despite the promotion of KUF awareness-level training by the Department of Health there is limited evaluation of the approach with mental health professionals in practice. This study reports on an evaluation of KUF training within a large mental health trust with three and six months follow up data. Qualitative evaluation three months after course completion indicates improved practice and application of course principles when working with individuals with PD.

As part of an attitudinal shift surrounding personality disorder stigma, a training package termed the Knowledge and Understanding Framework (KUF) is delivered in collaboration between experts by experience (EBE) and professionals. The purpose of this paper is to explore the narratives of EBE delivering KUF; in particular the impact of this role and its varying contexts.

Eight women took part in the study and a narrative analysis explored their stories.

The analysis suggested five temporal chapters: first, life before becoming involved: “Like being in a milk bottle screaming”; second, a turning point: “It wasn’t actually me that was disordered it was the life that I’d had”; third, taking up the trainer role: “It all just […] took off”; fourth, the emergence of a professional identity: “I am no longer a service user”; and fifth, impact on self, impact on others.

The use of qualitative literature is sparse within co-production research. The study therefore adds value in exploring in-depth experiences of the phenomena.

Personality disorder is reported to elicit strong emotional responses and negative attitudes in mental health staff (Bodner et al., 2015). The purpose of this paper is to provide an overview of the design and development of a co-produced e-learning training package for personality disorder awareness and an evaluation of its effectiveness. This study was carried out to explore if e-learning is an effective mode of training delivery for raising personality disorder awareness.

The e-learning was uniquely developed by subject matter experts working in co-production with people with lived experience. Self-reported measures were completed at three separate intervals to evaluate the effectiveness of the training: at pre-, post- and three-month follow up. Quantitative data were collected via these questionnaires.

The results from this evaluation show that e-learning is an effective mode of delivery for raising the awareness of personality disorder among mental health professionals, achieving similar outcomes to those reported following face-to-ace training.

Attrition at follow-up phase was high which was consistent with other similar studies. The evaluation was led by the lead contributors and in the geographical area of its development. The study was relatively small and the participants were self-selected, therefore findings should be treated with caution.

E-learning can provide flexible training to compliment and act as an alternative to face-to-face personality disorder training. E-learning may provide an alternative refresher course to knowledge and understanding framework or other face-to-face methods. Co-produced training can be mirrored within an e-learning programme, careful planning to ensure the service user voice is heard and that their lived experience is embraced is required.

This is the first evaluation of a co-produced e-learning only personality disorder awareness training. It is also the first paper to carry out a review of the published evaluations of personality awareness training in the UK with comparisons explored across the studies.

Workforce development is crucial to the offender personality disorder (OPD) service to provide contemporary, evidenced care and treatment. This study aims to provide an overview and the research evaluation results of a regional higher education programme delivered to a range of criminal justice workers used on the OPD pathway.

Three modules were developed and delivered; these are (1) enhancing understanding (20 students), (2) formulation and therapeutic intervention (20 students) and (3) relationships, teams and environments (17 students). A mixed-methods study evaluated participant confidence and compassion. Pre, post and six-month follow-up questionnaires were completed. Additionally, a series of focus groups were conducted to gain in-depth qualitative feedback with a cross-section of students across the modules (N = 7). Quantitative data was collected and analysed separately due to the three modules all having different content. Qualitative data was analysed, and a synthesis of qualitative findings was reported from data taken across the three modules.

A total of 52 students participated, drawn from three modules: Module 1 (N = 19); Module 2 (N = 18); Module 3 (N = 15). Confidence in working with people with a personality disorder or associated difficulties improved significantly following completion of any of the modules, whereas compassion did not. Results have been synthesised and have assisted in the future shaping of modules to meet the learning needs of students.

Further evaluation of the effectiveness of educational programmes requires attention, as does the longer-term durability of effect. Further research is required to explore the post-training impact upon practice, and further exploration is required and larger sample sizes to draw definitive conclusions related to compassion.

This unique model of co-production that draws upon the expertise of people with lived experience, occupational frontline and academics is achievable and well received by students and can be reproduced elsewhere.

The positive uptake and results of this study indicate a need for expansion of accessible OPD workforce training opportunities across the UK. Further research is required to explore student feedback and comparisons of effectiveness comparing different modes of training delivery, especially in light of the pandemic, which has forced organisations and higher education institutions to develop more digital and distance learning approaches to their portfolios.

This novel research provides an evaluation of the only higher education credit-bearing modules in the UK focussed solely upon the OPD workforce and aligned with the national drive for non-credit bearing awareness level training “knowledge and understanding framework” (KUF).

The purpose of this paper is to outline the qualitative evaluation of a training package delivered to offender managers (OMs) working to support the implementation of the national Offender Personality Disorder (OPD) pathway and to examine qualitative changes in the way participants approach case material pre- and post-training.

In total, 21 pre- and 21 post-training responses to a case vignette were recorded and used in the analysis. OMs were asked what they would like to know more about and what would they focus on with the individual in the vignette. The responses were matched and the vignettes pre- and post-training were identical except for the name of the (fictional) offender.

The responses were subjected to a thematic analysis and, whilst themes were similar both between questions and within each question over time, post-training responses focussed more on the offender’s relationship with the OM and showed a greater appreciation for the relevance of internal motivations (not just what but why). This tendency was less evident in all responses regarding risk/offending.

The OPD pathway is focussed on learning. The work is innovative and this paper adds to the body of early evidence which will hopefully inform future developments. In particular, the importance of involvement of probation stakeholders in the design and delivery of training is highlighted. In addition, it is expected that future research will focus on the impact of continued supervision for the participants in this study and, as such, this paper forms the beginning of a process of evaluating how and when various workforce development interventions are effective.

Abstract Steps have been taken towards improving the support given by the mental health workforce to those with personality disorder. But there is more to be done. This article argues that personality disorder is a significant public health challenge and not simply an issue for mental health and criminal justice services.

The authors of the previous paper “Staff and ex‐service user co‐working: a counselling service's enhanced response to multiple exclusion homelessness” feel that Paul's contribution and achievements can only be fully appreciated with reference to his own story. It is published here, to appear alongside the account of their joint experience of co‐working, as part of the series on personal perspectives on development work. It aims to give an account of one person's journey into homelessness and mental health problems in the context of multiple exclusion and homelessness.

This paper is a biographical account, with personal reflections.

There are no findings as such; this is an account of personal experience. It speaks for itself.

Fully personal accounts are rare, in research journals. Yet personal experience is the bedrock of research, and of outcomes. This account is published here, as a necessary balance to more formal, objective and statistical measures.

This paper aims to describe a novel collaboration between a worker and a former service user in developing two support groups – an art group and an “alcoholics anonymous group” self help group – at a central London “Wet” hostel for the homeless. The paper seeks to explore the issues raised for both workers in this experience.

The paper is a jointly written case study of innovative and reflective practice. It begins with an overview of policy frameworks and research that promote and advocate inclusion practice; then gives an account of the origins and development of the collaboration initiative; and concludes with reflections from each of the participants on what they have gained from the experience.

The main challenge for professionals lies in the need for “self‐reflective” practice and to challenge their own personal investments in the maintenance of their professional role and status. For ex‐service users, the challenge is to overcome low self‐confidence, the safety of the all‐too‐familiar “service user” role, and to realise that, despite real obstacles, a productive, useful contribution can be made to society. This can therefore be seen as a journey for both parties.

Working with multiple exclusion homelessness can leave professionals feeling isolated and deskilled, leading people with complex needs to be further excluded from services that feel that they do not fit their criteria. Tackling these issues requires time for reflection on the personal issues raised.

The paper provides unique learning and insight into the development and running of support groups, resulting from the novel collaboration between a worker and a former service user.