An evaluation of the difficulties and attitudes mental health professionals experience with people with personality disorders
Authors: Eren N. , Şahin S. 
Published: August 2015

Accessible summary
What is known on the subject?
Many studies indicate that working with people with a personality disorder is a real challenge, which is especially known by professionals, and it also displays different attitudes that can affect their professional stance. There is no specific study examining those difficulties, emotional reactions and attitudes of mental health professionals towards people with a PD in Turkey.

What this paper adds to existing knowledge?
We examined emotional reactions, difficulties and attitudes of mental health professionals towards people with a PD and also the interaction between these variables. We found a strong relationship between MHWs' feelings of boredom/discontent, guilt/pity and a tendency to display positive behaviours/an inability of establishing boundaries against people with a PD. Besides, a higher level of education resulted in reduced experience of difficulties while working with patients with a diagnosis of ‘PD’ among nurses.

What are the implications for practice?
Mental health professionals and especially nurses who spend most of their time working with people with PD in the inpatient services need to be well educated and be experienced in coping with patients' relational problems and emotional fluctuations, and also be aware of their own emotional reactions.
AbstractIntroductionWorking with people with a personality disorder (PD) can arouse strong feelings, and cause difficulties as well as different attitudes among mental health workers (MHWs). While attitudes towards people with PD and the difficulties experienced by MHWs have been previously investigated, the reciprocal relationship between the two has not been thoroughly investigated.Aim/QuestionThis study aims to investigate (1) affective reactions of MHWs to people with personality disorders, (2) the difficulties that MHWs experience while working with these patients, (3) their attitudes towards these patients, and (4) the interaction between these variables.MethodThe data for this study were collected through a Personal Information Questionnaire, the Difficulty of Working with Personality Disorders Scale and the Attitudes towards Patients with Personality Disorders Scale from 332 MHWs from several mental health clinics in Turkey, all of whom were experienced in working with people with PD.ResultsThe results indicate that the participants described ‘difficulty in forming a relationship, understanding the client, and estab lishing cooperation’ among the primary reasons of difficulties. This study also shows that there is a strong relationship between MHWs' feelings of boredom/discontent, guilt/pity and a tendency to display positive behaviours/an inability of establishing borders against people with PD.DiscussionThe findings of this study imply that the level of education, expertise, psychotherapy treatment and clinical supervision of MHWs all affect perceived difficulties and attitudes towards people with PD. It is also noted that among nurses, a higher level of education results in reduced experience of difficulties while working with patients with PD.Implication for practiceThe results foreground the need for specific skills to be developed in MHWs through theoretical training, case‐focused supervision and receiving personal psychotherapy for MHWs.