When patients in the the Coping and Succeeding Day Service (CAS) for people with personality disorder were asked the question: “What and who keeps you well?”, they answered that feeling more connected to friends, family and community resources was fundamental to keeping well. Peer support was also thought to be an important factor, with being around others who understood the condition and did not judge seeming especially beneficial. Group members did not place great importance on access to support from healthcare professionals, which may be due to the group members being at Phase 3 of their recovery journey (largely stabilised, with a focus on integration with the community and moving towards a life without services). However, there was recognition that at certain points in their lives professional support may have been more important in helping them to stay well, particularly when they were emotionally and behaviourally dysregulated and requiring interventions from Phase 1 of the treatment model. During Phase 1 of treatment, the group identified the importance of easy access to reliable information which would enable them to better understand their condition, emotions and behaviours.

The group at CAS identified that when working with healthcare professionals to support self-management, the most important factors to promote effective working included:

• Validation and recognition of the patient’s own experience and knowledge of their condition
• A supporting, collaborative relationship with the professional rather than a directive, controlling relationship, with the patient taking the lead in their own care planning
• Effective communication between the patient and those involved in their care and treatment
• A non-judgemental, understanding approach
• Specific approaches of value included:
• Support with goal setting
• Identifying trigger situations and further developing self-management skills which are effective for those situations
• Problem solving, trouble-shooting and planning ahead
• Provision of clear, accurate information about the condition
• Support to find out about local activities