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



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

Phil Willmot, Neil Gordon

ISBN: 978-0-470-97312-7 October 2010 288 Pages


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