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The Brief Education Supported Treatment (BEST) Project


What is the aim of the BEST project?

Young people spend a lot of their time at school or college. So making sure that young people with mental health difficulties receive the right support at school and college is important.

The aim of the project is to try out a new way of supporting young people experiencing problems like very strong feelings, difficulties getting along with other people, not knowing who they are as a person, doing risky things, and self-harm (symptoms of BPD). The new approach involves mental health services working with staff from the young person's school or college.

We want to find out whether this new way of providing support is feasible and whether it will be possible to run a future project testing whether it improves outcomes.


What is the borderline personality disorder (BPD)?


Borderline personality disorder (BPD) is a serious mental health problem. Symptoms of BPD include:

  • unstable emotions            
  • intense but difficult relationships
  • disturbed sense of self
  • impulsive behaviour, including self-harm

Around 3% of adolescents experience symptoms of BPD, roughly one young person in every classroom. These symptoms can make life very difficult for the young people who experience them and the people around them. 

BUT not all adolescents with BPD symptoms go on to meet diagnostic criteria for BPD. By intervening early, we hope we can reduce the number of young people who go on to develop BPD.


Why are we working with schools and colleges?

Although effective treatments for adolescent BPD symptoms exist, few young people get access to these treatments which are only offered by specialist services. As a result, opportunities to intervene early to stop symptoms becoming worse are often missed.

We think that if health professionals work together with colleagues from schools and colleges, more young people can be offered access to the support they need at an earlier stage.


What is the BEST intervention?

6 sessions:

  • The intervention is delivered over up to 6 sessions lasting approximately one hour each.

Delivered with schools and colleges:

  • All sessions are delivered at the young person's school or college by two members of staff working together – a member of pastoral staff from their school or college, and an NHS mental health practitioner.

Informed by MBT and DBT:
  • The intervention is informed by the existing treatments for adolescent BPD, Mentalisation-Based Treatment (MBT) and Dialectical Behavioural Therapy (DBT).


What will happen as part of the trial?



Who can take part in BEST?

To take part in the trial, young people must:
  • Be in Year 9-13 (aged 13-18 years)
  • Be enrolled at a participating school/college
  • Score more than 34 on the Borderline Personality Features Scale for Children
  • Have self-harmed in the past month
  • Be able to provide written informed consent (and parent/guardian consent for under 16s)

    What is the BPFSC?

    This is the questionnaire we use to check whether young people are experiencing the types of difficulties that would make the project a good fit for them:


    Which schools and colleges are taking part?

    We are extremely grateful to the following schools and colleges for supporting the project.
  • Acle Academy
  • Catch 22 Include
  • City College Norwich
  • East Coast College
  • East Norfolk Sixth Form
  • Hellesdon High School
  • Jane Austen College
  • Neatherd High School
  • Ormiston Victory Academy
  • Taverham High School
  • Thorpe St Andrew School
  • Sir Isaac Newton Sixth Form


    Are there any exclusion criteria?

    Unfortunately, young people are not able to take part in the trial if they:
  • Are currently receiving inpatient treatment or a specific psychological intervention, e.g. CBT, CAT, DBT (but they can be open to mental health services and receiving other treatments or support).
  • Have a moderate or severe learning disability.
  • Are experiencing psychosis or substance dependence requiring specialist treatment (young people with subthreshold psychotic symptoms or substance misuse will not be excluded).


How do I make a referral?

For more information about the study or make a referral, please contact the study team by emailing best@nsft.nhs.uk or telephone Brioney Gee (01603 974701) or Sophie Farthing 01603 974692.

If you know a young person who might be interested in taking part in the project, please speak to them (and their parent/carer if under 16) to see if they'd be interested in finding out more and, if they are, check they're happy for their contact details to be passed to the study team.

If you'd like to discuss whether the project would be a good fit for a young person, please get in touch. We can provide you with a pre-screening questionnaire to complete with the young person to help decide whether to make a referral.

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This project is funded by the National Institute for Health Research (NIHR) HS&DR (Grant Reference Number 17/09/31). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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