 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 and 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.
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 300-303 Bagot Street in the LaSalle Mews in downtown Kingston, and its hours are Tuesday through Thursday from 8:30 a.m. to 3:30 p.m. Before starting the program all applicants are assessed by the program psychiatrist. Up to 24 people can attend. There are no fees. Participants are asked to make a 15-week commitment to the program.
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.
Managing Powerful Emotions Group
Managing Powerful Emotions is a 10-week group offered several times a year for individuals who have difficulty with emotion regulation but who do not need the intensive treatment regimen of the Chrysalis Day Program. 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 themselves to this group.
Keep It Simple Skills Group
Keep It Simple Skills Group is a short-term immediate treatment group for individuals in the community or in hospital. Individuals participate in a series of six groups based on the four core modules of Dialectical Behaviour Therapy, including mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance.
It is a suitable group for individuals struggling with any of the following: impulsiveness, self-harm or self-damaging behaviours, unstable moods and emotions, and relationship difficulties. It may also be an appropriate treatment group for individuals who are unable to attend the Chrysalis Day Program or who are waiting for the Chrysalis Day Program or Managing Powerful Emotions group. Individuals may refer themselves to this group and do not need a referral from a health care professional.
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. Members of the Personality Disorders team also offer assessments and consultations in their area of specialty. Educational sessions for mental health professionals are offered periodically, including an eight-week course on the treatment of Personality Disorders.
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, and program effect on hospitalization. The principal researchers are Dr. Stephen McNevin, and Clinical Director Dr. Margo Rivera.
Contact/Referrals
Referrals are accepted from medical, mental health, and social service professionals. The referral source will be asked to complete a Consultation Form and send all useful collateral information. The Personality Disorders Service offers a full psychiatric assessment as part of referral, and the quality of the assessment report is dependent on the quality of the information provided by community caregivers. The family physician should be aware of involvement in the program. Individuals may self-refer to the Managing Powerful Emotions Evening Group and the Keep It Simple Skills Group.
Robin Westphal, Intake Coordinator
Tel: (613) 542-8344 ext. 301 or 0; Fax: (613) 542-1400
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