To think this therapy session should have ended with after care?

[DuvetDayEveryday]

I attend a weekly group therapy session for bpd. It's usually very helpful, we all discuss any difficulties we've had over the past week and work on strategies to overcome them.

This weeks topic was abuse avoidance. So we had to describe how we feel before, during and after an episode of self harm or overdosing etc. As usual, the session overran and we ended on quite a low note of discussing reasons for and methods of self harming. I came home in a bit of a state but fortunately dh is off work this week so I have support. The other ladies in the group are all single so went home to an empty house.

We have a group chat on fb and without exception all of us have struggled hugely this afternoon. Most of us have avoided SH for weeks until today and now it's the biggest thing on our minds.

I'm in half a mind to complain, just so this doesn't happen to the next group (it's a fixed course that runs twice a year with the same syllabus). Do you think that would be unreasonable?

I totally get the point of covering it in the group but feel it should have ended on a positive note talking about coping strategies rather than leaving it at the point we did.

Aibu? And how should I phrase it to the course leaders? They are lovely and I don't want to cause offence.

[ilovesooty]

Why does the session overrun? I think the course leaders need to address that and its impact on keeping people safe.

[DuvetDayEveryday]

It always does. We have a weekly topic with worksheets and never get to the end of the work before time runs out. It normally overruns by five minutes before they say that's enough, see you next week. I don't know whether it's bad planning or that we're a particularly talkative group, I don't think we are, particularly.

[Absentmindedwoman]

What is the type of therapy? Or is it just a support group?

The most favoured therapy for BPD is DBT, and one of the 'rules' for the group component is not to discuss self harming behaviours for this exact reason!

Please do complain, this sounds very badly thought out.

[Absentmindedwoman]

Do the therapy facilitators know you have a group chat on Facebook? That would ring alarm bells for me too. They should be explaining why it's better that you don't engage in friendships while in therapy together...

[DuvetDayEveryday]

It's a course called Stepps, I don't know how much it differs from dbt but it's what they offer in this area.

[DuvetDayEveryday]

They encourage us to be friends outside the group!

[LagunaBubbles]

Is this run by the NHS? One of the "rules" in the MBT therapy group my work run is strictly no contact outwith therapy, it blurs the boundaries.

[Elisheva]

You should not be discussing methods and specific episodes of self-harm and I would question the validity of a course that encourages you to do so. It is well established that discussing it is not helpful and inevitably triggering due to the compulsive nature of self harming behaviours. I would definitely raise concerns.

[LagunaBubbles]

MBT is mentalisation based therapy.

[DuvetDayEveryday]

It is an nhs group.

I'm feeling really fucking conflicted about it now. Lots of the strategies have been really useful but today's session was just horrendous. And it sounds like it breaks all sorts of therapy no nos.

[Absentmindedwoman]

That's appalling! Encouraging you to be friends, and discussing self harm

Crikey there is some woefully bad therapy out there.

Please complain. It's really good that you have a good support in your DH, but other people will have a very scant support network, and they are very vulnerable if they are caught up in 'therapy' like this with no boundaries (letting time over-run, encouraging friendships) and mismanagement of what is safe and appropriate (discussing self harm, my jaw is on the floor at that one!).

[PeaceLoveAndDiscoBiscuits]

Stepps is specifically for PDs so a world away from CBT etc. I understand the dynamic you've described.
I think the course facilitators will be pleased to have the feedback, if they're anything like my PD clinic. I suppose it's good practice for the coping strategies you've been practising, but I do understand how crap it feels to open up about something so raw and then be told, right, that's all the time we've got so see you next week. Take care and good luck with your recovery

[Absentmindedwoman]

DBT is for BPD too - there are similarities to CBT, as they are both behavioural therapies, but important differences.

I think this STEPPS programme sounds quite dangerous. Probably because it's being run on the cheap, with half-trained staff who don't have a deep enough understanding of PDs.

[DuvetDayEveryday]

It's actually run by a psychologist and a senior OT. Up until now I've had complete faith in them and the program and I feel very unsettled now.

[Absentmindedwoman]

It doesn't matter if somebody is a psychologist or not.

Plenty of psychologists do not have the specialist training or experience to work safely and effectively with people who have personality disorders. The people running this course are displaying a clear lack of knowledge by not upholding safe therapeutic boundaries. For personality disorders, safe boundaries are really, really important. To keep everyone feeling safe and contained.

[DuvetDayEveryday]

[Absentmindedwoman]

DuvetDayEveryday, I don't mean to upset you with my frank opinion. It just makes me cross when I see people getting a raw deal from unsafe therapy.

Please look after yourself.

[DuvetDayEveryday]

You haven't upset me. I'm just feeling really conflicted about therapy now. There's only a few weeks left so I'll see it through but I think today has shattered my trust in its efficacy.

[Janecc]

I don't have any advice to offer apart from please keep yourself safe. You have a right to complain.

[Becles]

Rather than jumping straight into a complaint how about just talking to the service via pals l? You could give constructive feedback on the course, give them time to listen and consider and let you know (if) how they are taking it on board.

Then if you are not happy you could always complain.

[DuvetDayEveryday]

Thank you. We have to have an individual meeting with the course facilitators when it all ends, so I think I'll probably bring it up then. I'll look into talking to PALS as well.