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How do high-risk young adult prisoners with emerging personality disorders describe the process of change in therapy?

Jake Shaw (London Pathways Partnership, London, UK)
Owen Forster (Pathways Service, London Pathways Partnership, Aylesbury, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 10 January 2018

Issue publication date: 23 January 2018




The purpose of this paper is to investigate the views of young adult prisoners with emerging personality disorders (PDs), who were assessed as posing a high risk of causing serious harm to others, on the process of therapeutic change in a non-residential treatment service in a UK young offender institute. The treatment model utilises an integrated approach, specifically adapted for the developmental needs of young adults and combining therapies for PD with offence focussed interventions and regular keywork.


In total, 13 participants, who had completed at least one year of therapy, were interviewed about their perspectives about what, if any, change had occurred and how any reported change had taken place. The interviews were transcribed verbatim and analysed via thematic analysis.


All participants described having made positive therapeutic change. Three overarching change themes were identified: mentalisation of others, self-knowledge and adaptive coping. Relationships with staff were described as the key mechanism through which change was achieved. Specific treatment interventions were mentioned infrequently, although keywork and generic individual therapy and groupwork sessions were also described as drivers to change.


The findings suggest the possibility of positive therapeutic outcomes for this complex service user group. They also suggest that the domains of change and associated mechanisms may be similar to those reported for other service user groups and in other settings.



The authors would like to thank Melanie Merola, Sara Rees-Evans, Bryony Fenton and Jenny Richards for assisting with data collection and transcription for this study.


Shaw, J. and Forster, O. (2018), "How do high-risk young adult prisoners with emerging personality disorders describe the process of change in therapy?", The Journal of Forensic Practice, Vol. 20 No. 1, pp. 32-41.



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