Search results

In his Presidential Address to the Library Association Conference at Eastbourne, in May 1949, Sir Ronald Adam, Chairman of the British Council, included a comprehensive description of the Council's library work in various parts of the world. This address, which also covered the other related activities, such as book‐exhibitions, book‐reviews, presentations of periodicals, and bibliographical publications, was printed in full in the Library Association Record of June 1949 and also in the Library Association's Papers and summaries of discussions at the Eastbourne conference. A reasonably up‐to‐date survey of the Council's libraries overseas is thus available in print, and the present article is accordingly more in the nature of footnotes to Sir Ronald's text than a repetition of the facts given by him. A conspectus of the system of Council libraries as of the end of 1950 is provided as an appendix to this article. Since the Eastbourne Conference there have, of course, been some developments, not all of them, unhappily, forward. There have been new libraries in India, Pakistan, Ceylon, and Indonesia. There has been a decrease in the work in West Africa, due to the transfer, as planned, of the library at Accra to an independent board. There has been a decrease in Europe, owing to the withdrawal, unplanned, of Council libraries, with the rest of the Council's activities, from Hungary, Bulgaria, Czechoslovakia. There have been one or two smaller libraries closed in other parts of the world, due entirely to cuts in the Council's budget. The year 1951/2 will almost certainly witness further, perhaps major, cessations of library work in several areas; and the general tempo of development is likely to be severely curtailed almost everywhere, simply because of sheer lack of financial means to carry on. In view of the peculiar financial relations which ultimately determine the library development of the Council, as they determine its every other activity, it may be helpful to place the Council's libraries in the setting of the Council's general structure.

It has often been said that a great part of the strength of Aslib lies in the fact that it brings together those whose experience has been gained in many widely differing fields but who have a common interest in the means by which information may be collected and disseminated to the greatest advantage. Lists of its members have, therefore, a more than ordinary value since they present, in miniature, a cross‐section of institutions and individuals who share this special interest.

Aarhus Kommunes Biblioteker (Teknisk Bibliotek), Ingerslevs Plads 7, Aarhus, Denmark. Representative: V. NEDERGAARD PEDERSEN (Librarian).

Assistance in the preparation of this issue of Aslib Proceedings has been forthcoming from an unusual quarter which augurs well for the New Year. ‘Blackie’, the large pure black Persian cat from no. 6 Belgrave Square, paid a goodwill visit to the Publications Officer's desk and personally signed some of the copy.

The purpose of this paper is to describe the evolution of the field of personality disorder since the publication of “Personality disorder: no longer a diagnosis of exclusion” in 2003.

A review of both the academic literature contained within relevant databases alongside manual searches of policy literature and guidance from the key stakeholders was undertaken.

The academic and policy literature concentrates on treating borderline and antisocial personality disorders. It seems unlikely that evidence will resolutely support any one treatment modality over another. Criticism has arisen that comparison between modalities misses inter and intra patient heterogeneity and the measurement of intervention has become conflated with overall service design and the need for robust care pathways. Apparent inconsistency in service availability remains, despite a wealth of evidence demonstrating the availability of cost-effective interventions and the significant inequality of social and health outcomes for this population.

The inclusion of heterogeneous sources required pragmatic compromises in methodological rigour.

This paper charts the recent developments in the field with a wealth of wide-ranging evidence and robust guidance from institutions such as NICE. The policy literature has supported the findings of this evidence but current clinical practice and what patients and carers can expect from services remains at odds. This paper lays bare the disparity between what we know and what is being delivered. The authors argue for the need for greater research into current practice to inform the setting of minimum standards for the treatment of personality disorder.

The purpose of this paper is to report on the content of local policies on engagement and observation written by National Health Service (NHS) organisations in England and Wales.

Engagement and observation policies were obtained from all (n = 61) NHS mental health trusts in England and health boards in Wales via a Freedom of Information Act 2000 request. Data were analysed using content analysis.

All organisations had a specific policy referring to either “observation and engagement” or “observation”. The policies varied considerably in quality, length, breadth and depth of the information provided. Significant variations existed in the terminology used to describe the different types of enhanced observation. Inconsistencies were also noted between organisations regarding: which members of the clinical team could initiate, increase, decrease and terminate observation; who could undertake the intervention (for example students); and the reasons for using it. Finally, despite rhetoric to the contrary, the emphasis of policies was on observation and not engagement.

This research has demonstrated the value of examining local policies for identifying inconsistencies in guidance given to practitioners on the implementation of engagement and observation. Further research should be undertaken to explore the impact of local policies on practice.

Local policies remain variable in content and quality and do not reflect contemporary research. There is a need to produce evidence-based national standards that organisations are required to comply with.

To the best of the author’s knowledge, this is the first research in 20 years examining the local policy framework for the implementation of engagement and observation.

National Institute for Clinical and Health Excellence guidelines (2009) state that low intensity psychological interventions should not be used for borderline personality disorder. However, an emerging body of evidence suggests brief interventions such as psychoeducation may be relevant for those presenting with borderline personality difficulties. The purpose of this study is to evaluate the benefit of learning about thinking, emotions and relationships (LATER), a co-produced psychoeducation programme for borderline personality difficulties in a community-based setting.

Participants (n = 125) self-referred to LATER, a group-based psychoeducation programme delivered at the [NHS Trust] Recovery College. Participants were assessed pre- and post-intervention using the tailor-made psychological education group evaluation scale, the borderline evaluation of severity over time and work and social adjustment scale. Paired t-tests were conducted on pre- and post-scores, and effect sizes were calculated.

After LATER, participants reported a significant decrease in negative thoughts and feelings, destructive behaviours and overall borderline symptom severity, but no significant increase in positive behaviours. Significant decreases were found in areas of work and social impairment. Participants’ overall understanding of personality difficulties significantly improved. Effect sizes were small to moderate.

Limitations of the study include the lack of a control group, adjustment for confounders and follow-up. Replication with a more robust methodology is needed.

This study contributes to the evidence for the usefulness of brief interventions for personality difficulties, particularly in the context of a stepped model of care and adds to the research on co-production.

Although support exists for the effectiveness of treatment for personality disordered offenders there is limited knowledge about the processes underlying the therapeutic change. The purpose of this paper is to explore the treatment experiences of six male psychopathic offenders who attended a social skills treatment component implemented within a high-secure personality disorder treatment service.

Interview transcripts were analysed by the lead researcher (first author) using interpretative phenomenological analysis (IPA) who compared and contrasted findings to develop superordinate themes across the group. External auditing analysis was conducted by the second author.

Several themes were identified that may indicate the unique ways this client group experienced treatment. These related to the importance of “group cohesion” with treatment progression and shared learning experiences, the significance of “therapeutic alliance” with treatment providers and perceived effectiveness of treatment, and the conflict participants experienced when acquiring and applying skills from their engagement in treatment. Participants identified aspects of the treatment component that facilitated the effectiveness of treatment and were effective in meeting their needs and some that would benefit from improvement.

Positive group dynamics are important. Operational staff inclusion within the facilitation team is beneficial. Attentiveness to participants’ specific responsivity needs is required. Supporting skill application post-treatment is important.

These findings add to the evidence base in relation to factors that support personality disordered offenders’ engagement within treatment. Areas that validate treatment delivery are highlighted, as are suggestions for change to maximise treatment gain for psychopathic and personality disordered offenders.

In the UK, the mental health treatment requirement (MHTR) order for offenders on probation has been underused. A MHTR service was established to assess the effectiveness of a partnership between a probation service, a link worker charity and an independent mental healthcare provider. Short-term structured cognitive behavioural interventions were delivered by psychology graduates with relevant work experience and training. Training for the judiciary on the MHTR and the new service led to a significant increase in the use of MHTR orders. The paper aims to discuss these issues.

A total of 56 (of 76 MHTR offenders) completed treatment in the first 12 months. A single cohort pre-post follow-up design was used to evaluate change in the following domains: mental health and wellbeing; coping skills; social adjustment; and criminal justice outcomes. Mental health treatment interventions were delivered under supervision by two psychology graduates who had relevant work experience and who were trained in short term, structured, cognitive behavioural (CBT) interventions.

Clinically significant changes were obtained on measures of anxiety and depression, and on measures of social problem solving, emotional regulation and self-efficacy. Ratings of work and social adjustment and pre-post ratings of dynamic criminogenic risk factors also improved. This new initiative has addressed the moral argument for equality of access to mental health services for offenders given a community order.

While the current initiative represents one of a number of models designed to increase the collaboration between the criminal justice and the mental health systems, this is the first within the UK to deliver a therapeutic response at the point of sentencing for offenders with mental health problems. The significant increase in the provision of MHTR community orders in the first year of the project has been associated with a decrease in the number of psychiatric reports requested that are time consuming and do not lead to a rapid treatment.

The purpose of this paper is to assess the effectiveness of a gender-specific group treatment programme for personality disordered (PD) women in a medium secure psychiatric setting.

In all, 56 consecutive admissions with a primary diagnosis of personality disorder (mostly borderline type) and co-morbidity were assessed according to their participation in, and benefit from, a core set of five manualised group treatments that focused on social and interpersonal deficits, instability of mood and problematic substance use. A single cohort pre-test post-test comparison design was used with evaluation based on global change over an amalgam of self-report group specific outcome measures.

In all, 70 per cent of patients attended three or more core groups, with attendance for each group ranging from 85 to 53 per cent. Between 65 and 77 per cent of patients showed a significant improvement on pre-group psychometrics. Patients who achieved a significant positive change in one group tended to do so in others. In all, 85 per cent of patients who completed two or more groups had overall positive direction of change scores. Those who benefited from treatment engaged more quickly, were more likely to have been admitted from hospital, to have previously engaged in therapy and to score lower on measures of impulsivity and personality pathology.

In a clinically representative study the absence of a control group limits the extent to which observed changes can be attributed to described interventions.

Findings reflect the importance of providing a broad clinical approach to changing cognitive behavioural functioning with PD patients in secure settings. They also highlight the need to improve ways of engaging patients at an earlier stage of hospital stay and of increasing the acceptability and uptake of relevant group treatments. Further evidence-informed service developments are needed to meet these challenges.

The study adds to a small literature on the clinical impact of a gender-specific group treatment programme for PD women in secure settings.