Positioning occupational therapy as a unique and integral component within case formulation and effective treatment for service users with personality disorder.

Personality Disorder is a serious mental health condition affecting between 5-12% of the UK population (Bolton et al., 2014). The NICE guideline for the treatment and management of borderline personality disorder (NICE, 2009) does not identify occupational therapy as an intervention. However, occupational therapists are routinely working with this population. There is an urgent need for occupational therapists to explain their theoretical models and evidence effective practice with this population. This seminar will explore the evolution of occupational therapy over thirteen years within the Leeds Personality Disorder Managed Clinical Network (LPDMCN). The task has been to construct a credible and relevant form of occupational therapy that engages effectively with the complexity of personality disorder. One challenge has been to keep an occupation-centred approach (Fisher, 2014) while working within psychologically driven frameworks. A further challenge has been to utilise suitable frames of reference that can help explain the multiple functions of service users' occupational lives. The occupational therapy process within LPDMCN is described. Relevant theoretical models are outlined and applied using case examples. Occupation-based and occupation-focused methods, tools and interventions are illustrated. The concept of 'occupational traps' is introduced and explored using clinical examples. It is argued that occupational therapy should be an integral component of the personality disorder care pathway because it: • produces an occupational profile which contributes to the overall case formulation • enhances the therapeutic relationship through 'doing together' • develops and reinforces self-regulation skills • can potentially move the service user beyond the identity of personality disorder. [ABSTRACT FROM AUTHOR]