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The Personality Disorders Service provides specialized care to non-psychotic individuals suffering from personality disorders who tend to experience intense and distorted thoughts and feelings and engage in self-destructive and socially inappropriate behaviours that are long-standing, hard to change, and affect many aspects of their lives.
Borderline Personality Disorder (BPD) is the most frequently treated. BPD is characterized by marked impulsivity and instability of mood and interpersonal relationships. People suffering from BPD frequently also experience depression, severe anxiety and eating disorders.
The service provides assessment, treatment, community consultation and education. A single interdisciplinary team guarantees continuity of care. The service has a strong community orientation and works closely with other health care professionals. [See Personality Disorders Service Brochure]
Chrysalis Day Program
Chrysalis Day Program is for people with severe, persistent symptoms that have not been resolved in other settings. Participants must be highly motivated to struggle toward responsible, independent functioning in the community. All Chrysalis participants live in the community and participate as outpatients. The program is located at 303 Bagot Street, Suite 300, in the LaSalle Mews in downtown Kingston, and its hours are Tuesday through Thursday from 8:30 a.m. to 3:00 p.m. Before starting the program all applicants will go through an intake screening. Up to 24 people can attend at one time. There are no fees. The program operates on a 15-week semester system.
Chrysalis is a highly structured and intensive treatment program that integrates Dialectical Behaviour Therapy with a psychodynamic approach in group therapy. The groups are safe communities where people can experience and reflect on the dynamics of interpersonal relationships. How they respond within the groups can be a source of insight into destructive personal patterns and a powerful catalyst for change. All Chrysalis participants develop short and long-term goals for personal change, and progress in meeting these goals is monitored in a weekly Goals group. A wide variety of other groups are also offered within the context of the day program, including: Choices, the core psychodynamic group, Orientation to Therapy, Effective Communication, Managing Powerful Emotions, Disordered Eating, Values, Art Therapy, Mindfulness, Gender and Sexuality.
At the end of each 15-week semester, participants review their progress with staff. If they have demonstrated excellent attendance, active participation and significant improvement in symptoms, and they show evidence of continuing need and motivation, they may re-register for a second semester. Those who are ready to graduate are asked to make goals for the next stage of their journey.
Participants' community health care providers are expected to continue to manage their ongoing care, and the Chrysalis Program is considered an adjunct to their efforts.
Community Groups
Choices Group [see brochure]
Choices is a 10-week, 2 1/2 hour group consisting of two parts: a structured psychotherapy group followed by dialectical behaviour skills training. Present-day dysfunctional patterns of thinking and behaviour are challenged through the review of weekly homework assignments based on Dialectical Behaviour Therapy emotion regulation and distress tolerance tools. This group may be suitable for individuals struggling with any of the following challenges: low self-esteem, emotional instability, self-damaging behaviour, unstable relationships, suicidal thoughts and/or behaviour.
To participate in this group, a referral and screening process are mandatory.
Seeking Safety Group
This group is intended for people who struggle with the combination of substance abuse and emotional/behavioural dysregulation. This group is designed to teach participants a set of skills to deal adaptively with their emotional suffering, by understanding their emotional and behavioural dysregulation and by making more constructive choices for themselves. The groundwork of this group includes lessons and homework on self-soothing, symptom management, relapse prevention, and harm reduction. Each participant makes weekly goals and is accountable to the group for meeting these goals.
To participate in this group, a referral and screening process are mandatory.
Managing Powerful Emotions Group [see brochure]
Managing Powerful Emotions is a 10-week psycho-educational group offered several times a year for individuals who have difficulty with emotion regulation. It is an educational group that teaches participants to use practical tools to understand their feelings and exercise control over emotional outbursts that create significant difficulties in their lives.
Individuals may self-refer to this group.
Keeping it Simple Skills Group [see brochure]
Keep It Simple Skills Group is a short-term skills-building groupfor individuals in the community or in hospital. Individuals participate in a series of six sessions based on the four core modules of Dialectical Behaviour Therapy, including mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance.
It is suitable for individuals struggling with any of the following: impulsiveness, self-harm or self-damaging behaviours, unstable moods and emotions, and relationship difficulties. This group may also be appropriate for individuals who are unable to attend the Chrysalis Day Program or who are waiting to attend the Chrysalis Day Program or the other community groups.
Individuals may self-refer to this group.
Distress Tolerence Skills-Building Group [see brochure]
The Distress Tolerance Skills-Building Group is an 8-week psycho-educational group. In this group, participants learn specific strategies to help tolerate emotional crises and intense emotions and examine the pros and cons of enacting destructive behaviour.
Individuals may self-refer to this group.
Consultation and Education
The program psychiatrist provides consultation to family physicians, community psychiatrists, agencies, and other caregivers. Consultations are typically in the area of medication management, treatment strategies, diagnosis, and issues that arise in psychotherapy. Other members of the Personality Disorders Service team offer assessments and consultations to professionals and community agencies in their area of specialty, as well as education in the understanding and treatment of personality disorders. We assist agencies in starting psycho-educational groups and provide placements for students in nursing, medicine, psychology, social work and nutrition.
Teaching and Research
Psychiatrists and psychologists with the Personality Disorders Service hold joint appointments at Queen's University and Providence Care and are active in teaching and research. Research interests include : The Treatment of Personality Disorders, The Biology of Stress, Learning Disabilities, Childhood Trauma, Sexual Orientation, Mindfulness, Eating Disorders, Program Effect on Hospitalization, Common Factors in Psychotherapy, Gender Identity, Posttraumatic Dissociation, Attachment, and Changing Role of Psychiatry at a Student Health Service.
The principal researchers are Dr. Stephen McNevin, Psychiatrist, and Director of the Division of Psychiatry, Queen’s Health Counselling and Disability Services; Dr. Margo Rivera, Clinical Leader of the Personality Disorders Service and Director of Psychotherapy, Department of Psychiatry, Queen's University, and Dr. Juliet Darke, Psychologist, Personality Disorders Service.
Referrals
All referrals and requests for service or consultation are to be directed to the Intake Coordinator, Paula Van Strien at (613) 542-8344 ext. 301; Fax (613) 542-1400.
Referrals for the Chrysalis Program, the Choices Group, and the Seeking Safety Group are accepted from family physicians, psychiatrists, and community mental health agencies. When a community mental health worker refers, the referral should be endorsed by the family physician, whenever possible.
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