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Implementing treatment programmes with integrity requires a clear statement of what is to be done in treatment, and treatment manuals do this to a greater or lesser degree. In correctional work, many treatment programmes are formally accredited, yet changes may need to be made after accreditation. Updating accredited programmes is important, but there is little formal guidance on post‐accreditation revision. This paper aims to report on practitioner feedback on one accredited programme – Control of Violence for Angry Impulsive Drinkers (COVAID) – with the aim of illustrating how practitioner feedback might be interpreted and used in revising treatment programmes.

The authors surveyed 20 treatment managers in prison and probation services, of whom 11 (55 per cent) responded. Responses were analysed thematically.

Respondents indicated that COVAID met a need for offenders, met the responsivity principle, and was well supported by documentation and post‐training support audit. Respondents offered suggestions for improvement. Some changes to the manual were clearly required; however, many of the suggestions need to be addressed in training. While initial training can be amended for future use, developmental support is another means of maintaining treatment integrity.

The number of treatment managers approached was small and responses were obtained from only 55 per cent of those contacted. Therefore, the views of respondents may not be representative of all treatment managers.

This report addresses the issue of programme re‐accreditation and the basis for revising treatments and treatment manuals.

Alcohol‐related violence is a social phenomenon and a serious public health issue that features regularly in the headlines. This article describes a cognitive behavioural treatment programme designed to help angry, impulsive drinkers, typically young white men, to control their violence, and outlines research undertaken to assess the programme's effectiveness.

The National Institute for Mental Health in England's (2003) paper, Personality Disorder: No Longer a Diagnosis of Exclusion, led to a need for effective treatments for people with personality disorders. Problem‐solving therapy (PST) is an appropriate treatment because, rather than trying to change basic personality structure, the aim is to help people with personality disorder to learn new skills to manage their emotional dysregulation and to work within their abilities to cope more effectively with life's problems. This overview describes the underpinning model of social problem‐solving and explains how PST aims to assist with problem‐solving difficulties.

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

The authors provide an overview of the studies conducted to date. These are a systematic review of the literature examining non‐completion of psychosocial treatment by people with personality disorder, a systematic review of assessments to measure treatment engagement, and a Delphi survey of both staff and patients' views on factors that impact on engagement in psychosocial treatment for this client group.

Poor engagement with psychosocial treatment is an issue for clients with personality disorder and rates of non‐completion are high. Discontinuation of treatment is associated with adverse clinical outcomes. Although a number of assessments exist for measuring engagement, none can be described as comprehensive and few are adequately validated. Engagement factors identified from the survey were broadly in keeping with previous work, but additional factors specific to this client group were identified. A treatment readiness model for people with personality difficulties is described.

Research outputs from the project are a set of specifications for good practice in facilitating engagement, and a web‐based training package aimed at helping staff improve their understanding of their clients' engagement issues.

The findings will be useful to service managers as well as clinicians working directly with people with personality difficulties. Improving client engagement will improve clinical outcomes and service cost‐efficiency.

There is abundant evidence that excessive alcohol use can adversely affect physical and mental health. Prior to incarceration, heavy drinking is common among prisoners. In this study, AUDIT information was examined in a sample of 126 male prisoners. Hazardous drinking was identified in 81%, and half had severe alcohol problems. Perpetrators of alcohol‐related violence are the most problematic drinkers of all. Examination of lifetime alcohol‐related violence indicated that those who are violent when intoxicated had more frequently been the cause of concern to others. These results are discussed in relation to alcohol treatments in the Prison Service for England and Wales.

In 2004, HM Prison Service launched an alcohol strategy that promotes treatment of alcohol‐related problems in imprisoned offenders. In commissioning services for prisoners, the needs of any prison population must first be established. The purpose of this study was to establish the need for an alcohol intervention in a local prison and to explore whether there might be a need to address alcohol‐related violence, rather than simply looking at alcohol misuse. The research identified the extent of the need for alcohol interventions in a UK prison for men, concluding that in this sample those who had also committed violent index offences might require interventions that specifically target alcohol‐related violence.

Sex offenders who refuse a place on a sex offender treatment programme are estimated to make up about half the prison sex offender population in England and Wales. It is important to motivate refusers to participate in treatment to reduce the likelihood of their re‐offending. In this pilot study we used the Personal Concerns Inventory‐Offender Adaptation (PCI‐OA), a semi‐structured motivational assessment, further adapting it for treatment refusers. We examined the effectiveness of the PCI‐OA (TR) with nine prisoners who had refused sex offender treatment (the treatment group) compared with nine refusers who received no intervention (the control group). The treatment group were at least 0.6 times as likely to show a positive motivational shift towards sex offender treatment as the untreated group. The practice implications of these results are discussed, and further evaluation of the PCI‐OA (TR) is recommended.

Evaluations of the impact of case formulation on outcomes for offenders are needed. The quality of case formulations may impact on outcomes, hence one essential aspect in outcome evaluation is quality assessment. A case formulation quality checklist (CFQC) was constructed and showed good reliability and internal consistency. However, feedback from users was the CFCQ could be improved. The purpose of this paper is to ascertain the opinions of professionals who had used the CFQC to provide a basis for its revision.

This was a qualitative study, in which ten professionals who had used the CFQC were asked their views about it. An inductive thematic analysis was used to organise the data.

Seven themes were identified. First, the importance of assessing quality in case formulation; second, the appropriate and comprehensive content of the CFQC; third, the practicality of the CFQC; fourth, validity and reliability issues; fifth, ways to improve the CFQC; sixth, potential as a training tool; seventh, limitations of the use of the CFQC. The CFQC was revised in light of these comments, producing the CFQC-R.

The reliability and consistency of the CFQC-R needs to be examined, as does validity, particularly predictive validity. This information will better enable research into whether case formulation improves outcomes for service users, and whether better quality case formulations lead to greater improvements.

The CFQC-R may be of value in training and supervising clinicians in constructing case formulations.

The CFQC-R is reproduced here so that researchers and practitioners may use the checklist.

Randomised controlled trial (RCT) methodology is viewed as the gold standard in evaluating the impact of interventions. Recruitment problems present one threat to the validity of RCTs, yet the barriers to recruitment are poorly understood. The purpose of this study is to identify obstacles to recruitment in a personality disorder (PD) treatment trial, with a view to suggesting ways of overcoming these obstacles.

A discussion group of 13 staff involved in the trial was held to identify barriers to recruitment. The information was subject to thematic analysis.

Eight themes were identified, and three overarching themes: reluctance to diagnose and preference for treating symptoms; increasing the burden and jeopardising other services; and lack of confidence in treatment and in treatment as usual.

Suggestions for minimising recruitment obstacles include careful site selection and protocol negotiation; education and training about PD; continued promotion of both research in general and the specific trial; and assurances about good research practice.

Recruitment is a common problem in RCTs, and the paper addresses this issue, not only in identifying obstacles to recruitment but also in offering suggestions to other trialists for minimising the obstacles.

Life‐long trauma histories and PTSD symptoms in 26 life sentence prisoners detained in a British Category B prison were examined. Prisoners were categorised on the basis of whether index offence violence resulted in human fatality, and whether reactive or instrumental violence was used in the index offence. Symptom measures included the Impact of Events Scale ‐ Revised and the Posttraumatic Stress Diagnostic Scale. Eight prisoners (31%) met all DSM‐IV criteria for current PTSD diagnosis. Partial PTSD was common in the remaining prisoners. Number of PTSD symptoms was unrelated to both the act of killing and the nature of violence. The rate of trauma prior to index offences was positively related to intrusive, avoidant and hyperarousal symptoms attributed by the prisoners to their index offence. The results suggest that prior trauma sensitised prisoners' traumatic reactions to their offences.