Personality disorder, primary care counselling and therapeutic effectiveness

Abstract

An evaluation of a primary care counselling service was conducted. Measures completed by clients were the CORE questionnaire (assessing subjective well-being, symptoms, functioning and risk) and the DIS(BI) (Swartz et al. , 1990) identifying cluster B personality disorders. Counsellors' written accounts of the benefits gained in therapy by their clients were also collected. At assessment, it was found that mean scores on the CORE questionnaire suggested the client group was experiencing similar levels of distress as those who attend other psychotherapy services; 50% of clients satisfied the DIS(BI) criterion for cluster B personality disorder. After therapy, there was a significant decrease in scores on all the subscales of the CORE questionnaire. Although those who scored above the criterion on the DIS(BI) indicating a personality disorder had significantly worse scores on the CORE at both pre and post therapy, as a group they nonetheless gained significant benefits from the counselling service. A content analysis method was utilised, based on previous thematic analyses of experiential therapies, to explore the counsellors' perceptions of the benefits of counselling for their clients. Counsellors perceived their clients as having changed in their experience of themselves or of their relationships and to have benefited from a safe, validating and supportive relationship. These benefits therefore relate to person-centred theory in which the counsellors were trained.