Capital Health Network

Borderline personality disorder (BPD) is a complex mental health issue that emerges in early adulthood and can cause ongoing behavioural issues and feelings that result in decreased functioning and increased distress over time. CHN, ACT’s PHN commissioned the University of Canberra to develop and implement a program that focuses on early intervention for mood regulation in emerging adults (aged 15-21 years) at high risk of BPD.

WOKE is an early intervention program that utilises dialectical behavioural therapy (DBT) performed by student clinicians under the supervision of skilled psychologists. The program teaches clients skills and techniques which can then be effectively adapted to assist with reducing psychological distress.

Over the last year, the program provided support to 52 young adult participants and members of their family. 100% of participants interviewed indicated that they felt safe and supported during the program and that they achieved a positive outcome. Of 51 participants who completed the program, 30 participants showed a clinically significant improvement on their Kessler Psychological Distress Scale (K10) scores, a measure of the likelihood of having a mental disorder (psychological distress). With 32 participants showing a clinically significant improvement on their Beck Depression Inventory (BDI) scores. Only two participants showed a deterioration on their K10 scores and one through their BDI scores. However, feedback indicates that these participants still found the program to be of assistance and achieved some positive outcomes.

In June, the WOKE Team had the opportunity to present to the ACT Branch of the Australian Psychological Society (APS). The audience acknowledged the considerable need for the program in the ACT region and the gap that it helped to fill. They were interested in how to refer to the program and outcomes from the evaluation. There was considerable discussion about how to sustain and expand the program because it was such a critical need in youth mental health.

Client story

Georgia (pseudonym) completed the Woke Online DBT Program with her guardian. She was referred to the program for support with emotion dysregulation, interpersonal problems, impulsivity, trauma, and a history of self-harm and suicidal ideation. These problems were interfering with her life at home, school and with friends. Georgia embraced WOKE skills willingly, practicing a range of mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness and middle path skills. She benefited greatly from the skills practice and from the warm, validating relationship she developed with her therapist.

After the program finished, Georgia demonstrated reduced impulsivity when in conflict with friends and family, an increased understanding and awareness of her emotional states, greater behavioural regulation in response to distress, and a reduction in emotional vulnerability. Her scores on the Life Problems Inventory suggested that after completing the WOKE Program, she was no longer showing elevated features of borderline personality disorder.

Georgia’s guardian worked with her own WOKE therapist, as well as joining some of Georgia’s sessions, and she expanded her skills greatly throughout the program. At the time of discharge, conflict at home was occurring about once a fortnight – a substantial reduction from the daily fights occurring at initial treatment and representing a major change in family dynamics. Georgia expressed a sense of mastery over her favourite distress tolerance skills and was able to use these skills to get through crisis situations without making things worse. Her favourite take-home message from the program summarised her learnings about self-validation and acceptance, “It’s okay to feel the emotions that you feel!”.

Testimonial from a Canberra psychiatrist

Dear WOKE team,
I am writing to thank you for your invaluable early intervention program and to provide feedback from several clients who have attended over the past year. I have referred several young people to your service with every single client reporting a favourable experience. In some cases, they have gone as far to say it has “been life changing”. The feedback I have received has referenced both your group and individual sessions as well as the option of including parents/carers in the process.

I hope that any positive feedback you receive will provide further evidence of the ongoing need for this service which I know relies on the provision of ongoing funding. Many thanks again for your endeavour and for the support you have provided to many of my patients.