The role of the nurse in treating people with personality disorder

One of the greatest challenges for mental health nurses is that of providing effective nursing interventions to people with personality disorder (Bland and Rossen, 2005; Cleary et al., 2002; James and Cowman, 2007; Moran and Mason, 1996), due to the complexity of this disorder and its manifestation via challenging behaviours that appear to defy rationality. The impact of the patients’ behavioural and emotional difficulties and distorted cognitions upon their interactions with others leaves staff charged with their care experiencing intense emotions. These contribute to counter-therapeutic interactions that at worst are punitive and, at best, provide short-term symptom management. People with personality disorder are considered to be ‘dislikeable’ clients (Bowers, 2002; Brody and Farber, 1996; Lewis and Appleby, 1988; Nehls, 1999) and this has contributed to them being shunted from service to service often oscillating between community, prison and inpatient settings.