{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T22:01:05Z","timestamp":1747173665783,"version":"3.40.5"},"reference-count":65,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Cogn. Psychother."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1352465822000339_as1\"><jats:title>Background:<\/jats:title><jats:p>Drop-out rates from evidence-based interventions for people with a diagnosis of personality disorder (PD) are high. The COVID-19 pandemic has likely exacerbated barriers to engagement with the introduction of virtual working. Virtual therapy has a good evidence-base for Axis I disorders, but limited research for Axis II disorders.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465822000339_as2\"><jats:title>Aims:<\/jats:title><jats:p>To investigate facilitators and barriers to engagement in a Tier 3 PD service virtual group programme.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465822000339_as3\"><jats:title>Method:<\/jats:title><jats:p>A virtual group programme was developed in collaboration with service members, and analysed members\u2019 attendance rates over a 5-month period pre- and post-COVID-19. Thematic analysis of semi-structured telephone interviews with 38 members is reported, describing their experience of the virtual group programme.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465822000339_as4\"><jats:title>Results:<\/jats:title><jats:p>Attendance rates were significantly higher pre-COVID (72%) than post-COVID (50%). Thematic analysis highlighted key barriers to attendance were: practical issues, low motivation, challenges of working in a group online and feeling triggered at home. Main promoters of engagement were: feeling valued, continued sense of connection and maintaining focus on recovery.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465822000339_as5\"><jats:title>Discussion:<\/jats:title><jats:p>The results suggest that the pandemic has exacerbated relational and practical barriers to engagement in a Tier 3 PD service. Ways of enhancing engagement are discussed, as well as preliminary recommendation for services offering virtual therapy to people with a diagnosis of PD.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1352465822000339","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T13:14:16Z","timestamp":1662729256000},"page":"629-643","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing member engagement in a Tier 3 personality disorder service during COVID-19: evaluation of a virtual group programme"],"prefix":"10.1017","volume":"50","author":[{"given":"Emma","family":"Smith","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3055-5301","authenticated-orcid":false,"given":"Cat","family":"Papastavrou Brooks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Clifford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Giles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Dring","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Startup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"S1352465822000339_ref66","doi-asserted-by":"publisher","DOI":"10.1080\/09515070.2020.1814694"},{"key":"S1352465822000339_ref18","first-page":"561","article-title":"Community and clinical epidemiology of borderline personality disorder","volume":"41","author":"Ellison","year":"2018","journal-title":"Psychiatric Clinics"},{"key":"S1352465822000339_ref52","unstructured":"Royal College of Psychiatrists (2020). 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