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Working Positively with Personality Disorder in Secure Settings: A Practitioner's Perspective

ISBN: 978-0-470-68380-4
288 pages
November 2010
Working Positively with Personality Disorder in Secure Settings: A Practitioner
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
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About the Editors and Contributors.

Series Preface (Eddie Kane).


Foreword (Kath Lovell).


Introduction (Phil Willmot and Neil Gordon).

Section 1: Context.

Chapter 1 From 'Anxious and Sad' to 'Risky and Bad': Changing Patterns of Referrals to the Personality Disorder Service (Jenny Marshall and Phil Willmot).

Chapter 2 Trapped in the 'Special Hospital': The Problems Encountered in the Pathway to Medium Secure Units (Amanda Tetley and Gopi Krishnan).

Section 2: The Treatment Process.

Chapter 3 What Works with Forensic Patients with Personality Disorder? Integrating the Literature on Personality Disorder, Correctional Programmes and Psychopathy (Phil Willmot and Amanda Tetley).

Chapter 4 Assessing Personality Disorder in Forensic Settings (Phil Willmot).

Chapter 5 A Treatment Pathway for High Security Offenders with a Personality Disorder (Sue Evershed).

Section 3: The Therapeutic Relationship.

Chapter 6 Attachment Theory and the Therapeutic Relationship in the Treatment of Personality Disorder (Louise Sainsbury).

Chapter 7 Therapeutic Style and Adapting Approaches to Therapy (Kerry Beckley).

Chapter 8 The Grey Areas of Boundary Issues When Working with Forensic Patients Who Have a Personality Disorder (Sue Evershed).

Chapter 9 One Patient’s Therapeutic Journey ('James' and Louise Sainsbury).

Section 4: Supporting and Developing the Therapeutic Workforce.

Chapter 10 Therapists’ Experiences of Therapy (Neil Gordon, Kerry Beckley and Graham Lowings).

Chapter 11 Making Sense of Interpersonal Dynamics: A Schema Focused Approach (Kerry Beckley).

Chapter 12 The Importance of Systemic Workforce Development in High Secure Settings (Andrea Milligan and Neil Gordon).

Chapter 13 Establishing a Supervision Culture for Clinicians Working with Personality Disordered Offenders in a High Secure Hospital (Andrea Daykin and Neil Gordon).

Section 5: Outcomes.

Chapter 14 An Individual Approach to Assessing Change (Jason Davies).

Chapter 15 Patient Experiences of Therapeutic and Anti-therapeutic Processes (Phil Willmot).

Chapter 16 Looking to the Future (Neil Gordon and Phil Willmot).


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Phil Willmot is a Consultant Forensic and Clinical Psychologist with the Personality Disorder Directorate at Rampton Hospital, Nottinghamshire, and a Senior Fellow of the Institute of Mental Health. He has over 20 years’ experience of working with personality disorder in forensic settings in prison and healthcare environments. He specialises in the assessment and the treatment of offenders with a diagnosis of personality disorder.

Dr Neil Gordon is a Psychotherapist who works as a senior clinician and supervisor in a high secure forensic setting. He is a Fellow of the Higher Education Academy, and a visiting Senior Lecturer at Sheffield Hallam University. He is currently seconded as a Senior Fellow to the Institute of Mental Health, Nottingham University, where he is the Head of Doctoral Programmes and Masters Programme Lead for the National Personality Disorder Knowledge and Understanding Framework (KUF) recently commissioned by the Department of Health and the Ministry of Justice.

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This book provides a timely reminder of the progress that has been made in working positively and therapeutically with personality disordered people in secure mental health settings. The editors and contributors have done an excellent job in communicating issues that arise at the clinical coal-face. Highly recommended.’
Professor Kevin Howells, Professor of Forensic Clinical Psychology, Institute of Mental Health and Nottingham University, UK

‘This book is essential reading for practitioners and service managers, researchers and even service users in facilities for people with personality disorder – in forensic mental health, prison and probation.  Using the Personality Disorder Service at Rampton Hospital as its focus, this book examines every aspect of the organised therapeutic response to personality disordered offenders – from changing patterns in referrals and care pathways to evidence-based assessments and treatments; from therapeutic engagement and style to boundaries; from workforce planning and development to the service user experience. This is a treasure chest of essential guidance from those in a position to lead the way.’
Dr Caroline Logan, Greater Manchester West Mental Health NHS Foundation Trust and University of Manchester, UK

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