In the video below, Janet Flaherty, Head of Communications at ELFT conducts an online interview with Nova Hart (Service Manager and Clinical Psychologist) and Tennyson Lee (Consultant Psychiatrist). This talks about the service and what it can offer to a range of people.
DeanCross Personality Disorder Service
DeanCross is a specialist service which works with adults (18+) living in Tower Hamlets who have aspects of their personality which contribute to difficulties, either for themselves or those they care about. We combine the disciplines of psychiatry, psychotherapy and psychology to provide a comprehensive and coherent treatment for our patients.
The service can be useful for people who frequently experience intense and difficult emotions, perhaps with sudden and extreme swings in mood states and feelings. People who come to our service may also struggle with frequent feelings of emptiness and difficulties in understanding who they are. These emotional problems may then lead to difficulties in forming and maintaining relationships, and less fulfilling lives.
When people find this is impacting upon life in a way that is all-encompassing, this can result in a diagnosis of personality disorder. This label is a contentious one and as a team we recognise this, however it is currently the term used to understand why some may find their life experiences have led them to seek support. We all have a personality but it is when certain aspects of how we think and feel interfere with our lives to the extent that it’s hard to find happiness alongside others (rather than thinking about us as ‘disordered’).
1st Floor Burdett House , Mile End Hospital
275 Bancroft Road
London
E1 4DG
United Kingdom
Deancross Personality Disorder Service
People referred to our service will have a detailed assessment which can take several meetings. During these appointments we want to work with our patients to better understand what’s led them to thinking about coming to our service and what they would like to change about their life. They will also be asked to complete questionnaires between sessions. It is hoped that the assessment will be helpful in itself, whether or not it leads to therapy within DeanCross.
If we both agree that therapy would be of benefit, the patient will join a group of 7-8 others who have similar experiences, meeting weekly for 90minute sessions. Alongside this they would also see a therapist in individual meetings weekly for 45minutes. The treatment offered at DeanCross is 18months
Before entering into the treatment programme we offer a nine-week group which focuses on psychological education to help understand more about being part of a therapeutic group and what our patient may want to get out of spending 18 months with us.
People referred to our service will have a detailed assessment which can take several meetings. During these appointments we want to work with our patients to better understand what’s led them to thinking about coming to our service and what they would like to change about their life. They will also be asked to complete questionnaires between sessions. It is hoped that the assessment will be helpful in itself, whether or not it leads to therapy within DeanCross.
Before entering into the treatment programme we offer a nine-week group which focuses on psychological education to help understand more about being part of a therapeutic group and what our patient may want to get out of spending 18 months with us. If we both agree that therapy would be of benefit, the patient will join a group of 7-8 others who have similar experiences, meeting weekly for 90minute sessions. Alongside this they would also see a therapist in individual meetings weekly for 45minutes. The treatment offered at DeanCross is 18 months.
We offer two evidence-based treatment options for people who have been diagnosed with Borderline Personality Disorder (also called Emotionally Unstable Personality Disorder): Mentalization–Based Treatment (MBT) and Transference Focused Psychotherapy (TFP). These treatments are both drawn from psychoanalysis, they are closely linked and complementary. The treatments are focused on the here and now as opposed to focusing on past trauma. These treatments are given in a group therapy program. Clinical trials have shown that both treatment options are effective treatment for people with personality disorder.
Mentalization-Based Treatment: Mentalizing is our ability to identify what is going on in our own minds and that of others. If we are mentalizing successfully, we are better able to understand what is going on for ourselves and others, for example in relation to feelings and actions. This understanding helps us to get on better with others. In some mental health conditions, such as personality disorders, individuals can find it more difficult to mentalize, especially when in a stressful situation or encounter. This can lead to misunderstandings regarding emotions, thoughts and actions, and result in breakdowns in communication and relationships. Helping people to develop their own mentalizing skills as a therapeutic programme forms the core of MBT.
Watch this video of Peter Fonagy explaining what Mentalization is >>
Transference Focused Psychotherapy: TFP is grounded in contemporary psychoanalysis but has made specific modifications of technique to make it more helpful to people meeting the diagnostic criteria for personality disorders. It has a particular focus on structuring the treatment of patients and assessing and treating the way the individual’s personality is organised, to allow the individual to develop a more coherent and understandable sense of their identity.
We also offer 2 workshops for the ‘significant other’ of an individual currently in treatment with us. The aim of these workshops is to enhance the understanding of the significant other, so that they can better support the work that the individual is doing here at DeanCross. Some of the things included in the workshop are:
What is Personality Disorder;
How Personality Disorder can affect relationships;
What is Mentalization;
The role of therapy;
How you can look after your own well-being;
How to access resources and support.
In addition to our treatment programme, we also emphasise service development, education and research.
Outreach and Service Development
We support and consult to our referring services (health and social services, and third sector organisations) and those who access our services. We are actively involved in the London Transformation programme which aims to integrate services more into the community and with voluntary and third sector community groups.
We also run a consultancy to organisations (either within the NHS or the third sector) regarding working with patients who may experience difficulties associated with the diagnosis of personality disorder.
Education
We have an active teaching, supervision and training programme, and are also involved in education of the public in personality disorder. Here are recent educational items:
BBC Radio 4 - Radio 4 in Four - Is narcissism on the rise?
Seriously... - I Feel for You: Narcs and narcissists - BBC Sounds •
Vice magazine interview - 'Inside the Reddit group for self-identified narcissists'
Research
Our research unit, The Centre for Understanding of Personality Disorder (CUSP), is highly active and clinically driven. We also work with people who have lived experience of the difficulties associated with the diagnosis or personality disorder. CUSP is attached to the Centre for Psychiatry, Wolfson Institute, Barts and The London School of Medicine & Dentistry and the Department of Psychiatry, Oxford University.
Selected Research Papers
- Kanter-Bax O, Neranzis G, Lee T An Aid to Learning Psychodynamic Psychotherapy for Trainee Psychiatrists in the UK: Use of Transference Focused Psychotherapy BJPsych Bulletin
https://www.cambridge.org/core/journals/bjpsych-bulletin/article/transferencefocused-psychotherapy-as-an-aid-to-learning-psychodynamic-psychotherapy-qualitative-analysis-of-uk-psychiatry-trainees-views/EFED005B9289956CA8C55363652B27C2 - Ventura Wurman T, Lee T, Bateman A, Fonagy P, Nolte T. Clinical management of common presentations of patients diagnosed with BPD during the COVID-19 pandemic: The contribution of the MBT framework. Counselling Psychology Quarterly. https://www.tandfonline.com/doi/full/10.1080/09515070.2020.1814694
- Roughley M, Maguire A, Wood G, Lee T. Referral of patients with emotionally unstable personality disorder for specialist psychological therapy: why, when and how? BJPsych Bulletin 2020 http://dx.doi.org/10.1192/bjb.2020.48
- Lee T, Hersh G Managing the Clinical Encounter with Patients with Borderline Personality Disorder in a General Psychiatry Setting :Key Contributions from Transference-Focused Psychotherapy (TFP) BJPsych Advances Volume 25, Issue 4 July 2019 , pp. 229-236 Managing the clinical encounter with patients with borderline personality disorder in a general psychiatry setting: key contributions from transference-focused psychotherapy | BJPsych Advances | Cambridge Core
- Hossain A, Malkov M, Lee T, Bhui K. Ethnic Variation of Personality Disorder of 6 years of hospital admissions in East London Mental Health Services BJPsych Bull 2018, 42, 157-161. https://www.cambridge.org/core/journals/bjpsych-bulletin/article/ethnic-variation-in-personality-disorder-evaluation-of-6-years-of-hospital-admissions/9A9454F9FC03A4EA4C35DA3CE96D4561
We are contracted to provide treatment for people living in the borough of Tower Hamlets. We are unable to accept out-of-area referrals. Referrals to DeanCross are via a single point of entry, which are the Community Mental Health Teams in Tower Hamlets. GPs should make referrals to the CMHTs in the first instance.
Please see the Guidelines for Referrers (LINK-attached) document on this website. Overall:
- We do not accept self-referrals, so anyone thinking our service might be for them should:.
- Be resident in Tower Hamlets and over 18 years of age
- Be willing to consider a psychological approach to help with their difficulties, specifically those difficulties within relationships
- Be willing to consider working in group treatment.
- Not be dependent on alcohol or other drugs
- Not have a BMI of below 18.5
We are happy to discuss potential referrals with professionals by telephone and this is often the best way to commence a referral. We endeavour to respond to calls within 24 hours.
If you think that you may have difficulties that relate to the diagnosis of personality disorder, and you are resident in Tower Hamlets, please make an appointment to discuss with your GP in the first instance. They would be able to consider your difficulties and make the best onward referral for you which may be to the local Community Mental Health Team, or other services who may be able to support you.
If DeanCross accepts a referral from the CMHT, then we would write to you within two weeks to ask you to call and book an appointment with us.
Urgent Crisis Support
- If you feel in crisis and are unsure of how best to cope, you can call the ELFT City & Hackney Mental Health Crisis Line on FREEPHONE: 0800 073 0003. This is a 24 hour / 7 day a week service that can be accessed in times of crisis.
- If you live in Newham, City & Hackney, Luton or Bedfordshire visit the ELFT Get Help In An Emergency resource page. (ADD LINK TO: CONTACT US > GET HELP IN AN EMERGENCY)
- For more information on NHS mental health crisis support visit Where to get urgent help for a mental health crisis.
Further Information
- BPD Factsheet from Rethink: https://www.rethink.org/diagnosis-treatment/conditions/borderline-personality-disorder-bpd
- Royal College of Psychiatry information http://www.rcpsych.ac.uk/healthadvice/problemsdisorders/personalitydisorder.aspx
- Lee T Stormy Lives A Journey Through Borderline Personality Disorder. London: Muswell Hill Press London New York 2016 Ch 1 (LINK)
DeanCross Videos
- Interview on Centre for Understanding Personality Disorder (CUSP) with Emma Larsson, Kam Bhui and Tennyson Lee (forthcoming, April 2021)
- Presentation- Referral of patients with Emotionally Unstable Personality Disorder for Specialist Psychological Therapy: Why, When And How? Matt Roughley, Amy Maguire, Grace Wood and Tennyson Lee
Testimonials & Awards
DeanCross has been recognised for its service and clinical excellence and is an award-winning service (including the Robert Dolan Leadership award in ELFT 2018, and winner of the Royal College of Psychiatry Psychiatric team of the year award 2019: Working-age Adults.)
“It was really helpful to be in a group setting and explore and relate to other patients without feeling judged.”
[I gained a] “proper treatment plan, which didn’t make me feel sick, damaged or bad”.
“The things I found most helpful was the accessibility, the work, the therapy, the therapists.”
“I really appreciate all the help I'm receiving. Thank you all very much!”
“Generally, my experience here has been very positive and helpful.”
“Thank you, Deancross has really helped me in many ways. Keep doing what you are doing.”
“(DeanCross) was the first time in my life that I have ever felt truly understood, both by staff and other service users.”
“This service has helped me regain my life and taught me many new ways of thinking that has been entrancing. I have improved a great deal since my initial assessment and this is undoubtedly down to the treatment I have received at DeanCross. I would recommend the service to anyone diagnosed with a personality disorder while the process is not easy if you can stay with it, it offers a genuine hope for improvement.”
“DeanCross has clearly become a big part of my life and the work I have done there has allowed me to improve a great deal. I will miss the support and the treatment and the supervised improvement I've experienced since April 2014… I am very grateful to have received treatment by people who genuinely seem to care who treat us as humans. Even when I'm being challenged I don't generally feel my thoughts or feelings are being dismissed nor am I made to feel small or irrelevant for having them.”
“DeanCross is very difficult. I learned a way of thinking that kept me safe and alive”
"We would like to offer you both, Amy and Nikolas, and your team, our heartfelt thanks for all your work with [service user name]. No words can explain how important it has been, not only to her, but to her family also”
“My time at DeanCross has been life-changing. It offers something unique. I found that other services discharged me or judged me for these behaviours (self-harm, not attending, getting angry) when these were the very reason that I needed help” [1]
“I am very happy with the service, with the therapy, with the help I have and will have.”