Personality disorder in young people: Evaluation of Screening measures And relational Peer Work (EScAPe)

Relational peer work Relational peer work is a manualised intervention that aims to provide support and information from the perspective of a peer with lived experience of mental ill-health. Over 13 weeks, participants will be offered up to 10 individual 50-minute relational peer work sessions. These sessions will be delivered weekly, face-to-face (either in person and/or via videoconferencing), and at a location based on participant preference (e.g. at a clinical site and/or in the community). A 13-week period was chosen to allow for missed sessions. Sessions will be semi-structured, with core parts covered including: (i) improving psychosocial functioning, (ii) reducing distress, (iii) increasing self-care, and (iv) increasing appropriate help seeking. The sessions will be under pinned by the values of peer work but supported but a manual which has been co-developed alongside peer workers, specifically for this study. Peer workers will be aged between 18 and 30 years (inclusive), with lived experience of mental ill-health. They will bring knowledge of ‘transdiagnostic’ experiences, such as seeking treatment, receiving a diagnosis, and experiencing distress. Each peer worker will have undergone Orygen’s comprehensive peer worker training. This includes an online, self-paced, module, 'Youth Mental Health Peer Support 101', which typically takes four hours to complete. This module is available publicly at: https://www.orygen.org.au/Training/Resources/Peer-work/Modules. The peer workers will also attend two interactive, half-day workshops on relational peer work, designed specifically for this study. The first will cover a brief overview of the relational model underpinned by cognitive analytic therapy (CAT), and provide a reflective model for assisting peer workers to better understand young peoples’ sometimes challenging relational patterns and self-defeating coping strategies. The second will provide an overview and discussion of what constitutes a personality disorder, how this might emerge and why it is important to intervene early. This session will cover myths and stigma, and will outline the principles of relational clinical care (Chanen et al, 2008) and how these fit with the principles of peer work. Each session will aim to provide some didactic material and links to resources in a conversation style designed to facilitate participants to engage in reflection and discussion. A senior clinical psychologist and a senior peer worker will deliver these workshops. The peer workers will receive regular supervision from a senior clinical psychologist and a senior peer worker. Treatment attendance will be recorded by the peer workers, using a measure developed for this study. Treatment fidelity will be managed via regular supervision sessions and use of standardised training resources. Fidelity will be assessed with the Peer Specialist Fidelity Measure (Chinman et al, 2016).