Working Positively with Personality Disorder in Secure Settings

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.

• About the Editors and Contributors xSeries Preface xivEddie KanePreface xviiForeword xixKath LovellAcknowledgements xxIntroduction 1Phil Willmot and Neil GordonSection 1: Context 11Chapter 1 From ‘Anxious and Sad’ to ‘Risky and Bad’: Changing Patterns of Referrals to the Personality Disorder Service 13Jenny Marshall and Phil WillmotChapter 2 Trapped in the ‘Special Hospital’: The Problems Encountered in the Pathway to Medium Secure Units 22Amanda Tetley and Gopi KrishnanSection 2: The Treatment Process 33Chapter 3 What Works with Forensic Patients with Personality Disorder? Integrating the Literature on Personality Disorder, Correctional Programmes and Psychopathy 35Phil Willmot and Amanda TetleyChapter 4 Assessing Personality Disorder in Forensic Settings 49Phil WillmotChapter 5 A Treatment Pathway for High Security Offenders with a Personality Disorder 66Sue EvershedSection 3: The Therapeutic Relationship 91Chapter 6 Attachment Theory and the Therapeutic Relationship in the Treatment of Personality Disorder 93Louise SainsburyChapter 7 Therapeutic Style and Adapting Approaches to Therapy 115Kerry BeckleyChapter 8 The Grey Areas of Boundary Issues When Working with Forensic Patients Who Have a Personality Disorder 127Sue EvershedChapter 9 One Patient’s Therapeutic Journey 147‘James’ and Louise SainsburySection 4: Supporting and Developing the Therapeutic Workforce 157Chapter 10 Therapists’ Experiences of Therapy 159Neil Gordon, Kerry Beckley and Graham LowingsChapter 11 Making Sense of Interpersonal Dynamics: A Schema Focused Approach 172Kerry BeckleyChapter 12 The Importance of Systemic Workforce Development in High Secure Settings 188Andrea Milligan and Neil GordonChapter 13 Establishing a Supervision Culture for Clinicians Working with Personality Disordered Offenders in a High Secure Hospital 200Andrea Daykin and Neil GordonSection 5: Outcomes 211Chapter 14 An Individual Approach to Assessing Change 213Jason DaviesChapter 15 Patient Experiences of Therapeutic and Anti-therapeutic Processes 232Phil WillmotChapter 16 Looking to the Future 243Neil Gordon and Phil WillmotIndex 247