Working Positively with Personality Disorder in Secure Settings

Working Positively with Personality Disorder in Secure Settings provides a positive, compassionate and evidence-based guide to working with patients with personality disorders. Unique in both its coverage and in its positive and evidence-based approach to working with patients with personality disorders Written with a practical focus by experienced practitioners in the field Offers a broad approach, with contributions from forensic and clinical psychologists, nurses, and therapists Covers therapy and therapeutic relationships, and issues of supervision, workforce development, treatment evaluation, team dynamics and managing boundaries Includes a strong patient focus and a number of personal accounts from patients who have received therapy themselves

About the Editors and Contributors x Series Preface xiv Eddie Kane Preface xvii Foreword xix Kath Lovell Acknowledgements xx Introduction 1 Phil Willmot and Neil Gordon Section 1: Context 11 Chapter 1 From ‘Anxious and Sad’ to ‘Risky and Bad’: Changing Patterns of Referrals to the Personality Disorder Service 13 Jenny Marshall and Phil Willmot Chapter 2 Trapped in the ‘Special Hospital’: The Problems Encountered in the Pathway to Medium Secure Units 22 Amanda Tetley and Gopi Krishnan Section 2: The Treatment Process 33 Chapter 3 What Works with Forensic Patients with Personality Disorder? Integrating the Literature on Personality Disorder, Correctional Programmes and Psychopathy 35 Phil Willmot and Amanda Tetley Chapter 4 Assessing Personality Disorder in Forensic Settings 49 Phil Willmot Chapter 5 A Treatment Pathway for High Security Offenders with a Personality Disorder 66 Sue Evershed Section 3: The Therapeutic Relationship 91 Chapter 6 Attachment Theory and the Therapeutic Relationship in the Treatment of Personality Disorder 93 Louise Sainsbury Chapter 7 Therapeutic Style and Adapting Approaches to Therapy 115 Kerry Beckley Chapter 8 The Grey Areas of Boundary Issues When Working with Forensic Patients Who Have a Personality Disorder 127 Sue Evershed Chapter 9 One Patient’s Therapeutic Journey 147 ‘James’ and Louise Sainsbury Section 4: Supporting and Developing the Therapeutic Workforce 157 Chapter 10 Therapists’ Experiences of Therapy 159 Neil Gordon, Kerry Beckley and Graham Lowings Chapter 11 Making Sense of Interpersonal Dynamics: A Schema Focused Approach 172 Kerry Beckley Chapter 12 The Importance of Systemic Workforce Development in High Secure Settings 188 Andrea Milligan and Neil Gordon Chapter 13 Establishing a Supervision Culture for Clinicians Working with Personality Disordered Offenders in a High Secure Hospital 200 Andrea Daykin and Neil Gordon Section 5: Outcomes 211 Chapter 14 An Individual Approach to Assessing Change 213 Jason Davies Chapter 15 Patient Experiences of Therapeutic and Anti-therapeutic Processes 232 Phil Willmot Chapter 16 Looking to the Future 243 Neil Gordon and Phil Willmot Index 247