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The purpose of this paper is to explore staff and prisoner experiences of a newly implemented Personality Disorder Service (PDS) within a category B male establishment.

A semi-structured interview was used to explore the experiences of seven male category B PDS prisoners and eight PDS members of staff (four National Health Service (NHS) clinical staff and four prison service staff) from a multi-disciplinary team (MDT). Interviews were transcribed verbatim and thematic analysis was completed.

Prisoner sample: one overarching theme “environment” organised two themes: “enabling factors” and “disabling factors” which had a subtheme “integrating men who have sexually offended onto the unit”. Another theme “opportunities for self-development” was identified. Staff sample: an overarching theme “environment” organised two themes: “enabling factors” and “disabling factors”. An overarching theme “multi-disciplinary working” organised two themes: “working in partnership” and “cultural differences in working practices”. Two further themes were: “professional development” and “stressors”.

This study focused on a small sample of staff and prisoners and their experiences of a newly implemented PDS. In addition, both staff and prisoners volunteered to take part in the study, and therefore may not be a representative sample. Consequently the results cannot be generalised to other establishments or PD services.

Staff and prisoner experiences indicate that a multi-disciplinary approach to personality disorder services is desirable and can be effective. Prisoners are gaining experiences of positive therapeutic relationships with staff and hope that their experiences of the PDS will reduce their risk of reoffending. Staff experiences indicate that the integration of two services presents challenges and that they are working to overcome these. It may be advantageous for the impact of cultural differences within a MDT to be explored further.

This is the first study that explores the experiences of the MDT and prisoners of the newly implemented PDS. The PDS forms part of the new development under the National Offender personality disorder pathway.

The purpose of this paper was to examine the impact of a highly structured, formulation focused consultation process on knowledge and attitudes towards personality disorder and on perceived practice with personality disordered offenders. Consultation was delivered by the Yorkshire/Humber regional Pathway Development Service (PDS). This pilot study sought to inform the development of this service and the support offered to probation Trusts across Yorkshire/Humber to implement the national Personality Disorder Offender Pathway.

Consultation was offered to a number of offender managers working in the Yorkshire/Humber region. The impact of the consultation on their knowledge and understanding of personality disorder in general was examined as was their attitudes to working with this population and their perceived confidence and competence in delivering supervision to each individual.

The findings from this small pilot study would suggest that the structured format used by the Yorkshire PDS was helpful in enhancing the probation officers’ knowledge and understanding of personality disorder as well as their perceived confidence in and attitudes towards working with individuals with a personality disorder.

The study indicates that the structured format used by the PDS is of value and may be applied to the support offered to probation Trusts across Yorkshire/Humber as they implement the community specification of the national Personality Disorder Offender Pathway.

The purpose of this paper is to describe the evaluation of the “Living with a Personality Disorder” group (Morris, 2011a). This intervention is a psycho-education group for women with an intellectual disability (ID) and a personality disorder (PD). It draws on psycho-education, biosocial theory (Linehan, 1993) and compassionate mind approaches (Gilbert, 2009). It aims to increase knowledge of personality, PDs, to increase awareness of the “non-disordered” parts of self and to increase knowledge of psychological treatments for PD’s.

The intervention was delivered to women detained in a specialist women’s learning disability forensic service. It was delivered over 12 group and two individual sessions. The Knowledge of Personality Disorders Questionnaire (D’Silva and Duggan, 2002), the Self-Compassion Scale (Neff, 2003), the University of Rhode Island Change Assessment scale (McConnaughy et al., 1983) and a series of Likert scale questions and statements were used to assess the utility of the intervention. The intervention was piloted between 2012 and 2014 in a series of small groups. The lead facilitator for each intervention was a registered psychologist with training in dialectical behaviour therapy.

Completing the intervention resulted in an increase in knowledge of PDs, treatments, increased self-compassion and therapeutic optimism and awareness of the limitations of a PD diagnosis.

A new intervention that may increase knowledge of PDs, of personal strengths and increase optimism about change that may be a useful component to the treatment for service users with PDs and an ID.

The range of prevalence of personality disorder (PD) found in people with intellectual disability (ID) has been reported as vast, and has included data from dissimilar settings. The purpose of this paper is to review the reported prevalence of PD in the general population of people with ID, and to consider how different and changing ideas about PD have affected these rates.

Cross-sectional studies of the prevalence of PD in people with ID were identified. The quality of the studies was considered, along with how cases of PD were identified.

Six studies were included. The reported prevalence of PD in people known to have ID ranged from 0.7 to 35 per cent. Possible reasons for this wide range included different views of PD and methods of assessment.

The wide range of findings suggests that methodological differences are significant. Consideration to how clinicians should respond to the overlap of impairment between ID and PD may improve the conceptual clarity of PD, informing future epidemiological research.

This review was limited to studies of samples likely to be representative of the general ID population. The range of prevalence estimates was narrower than previously reported, and more likely to reflect the true prevalence rate of PD amongst people who have ID. Consideration was also given to how different ideas of PD led to different methods and may have contributed to variance in the results.

The purpose of this paper is to highlight the findings of a service evaluation project assessing the impact of team consultation to criminal justice staff working with personality disordered offenders.

A qualitative design using content analysis of focus groups and individual semi-structured interviews.

Criminal justice staff report increased awareness and understanding, use of a person-centred approach, development of formulation skills and defensible practice following team consultation.

This paper will be of interest to practitioners who offer and/or receive consultation for work with offenders with personality disorder. Suggested changes to team consultation formats may be of interest to services involved with the Offender Personality Disorder Pathway.

This paper contributes towards the emerging literature on the role of consultation and formulation on workforce development for individuals with personality disorder. It also contributes to the evaluation of the services offered by this specialist team as they support probation Trusts across Yorkshire/Humber to support the community specification of the national Offender Personality Disorder Pathway.

The offender personality disorder (OPD) pathway provides services to people with histories of offending and traits of personality disorder (PD) who are at high risk of violent re-offending. The residential provisions have been developed as psychologically informed planned environments (PIPE), in which socially creative activities form an integral part. Ryan et al. (2018) suggest that social and creative activities offer individuals experiences to increase their understanding of themselves and others. The purpose of this study is to complete a service evaluation exploring how people who live on an OPD PIPE in a woman’s prison make sense of their experiences of a drumming, singing and ceremony group, which was offered to them as part of their provision PIPE.

Semi-structured interviews were conducted with six service users (between 19 and 42 years old).

Thematic analysis identified three themes: emotional regulation, belonging and connectedness and humanising spaces.

This study used a small sample (n = 6), and all participants were accessing the same OPD provision PIPE. Further, participation was voluntary, and results found may relate to possible biases in a self-selecting sample. The interviewer knew the participants through their clinical work, and despite being informed that participation in this research project would have no bearing on their treatment pathway, some may have participated as a way to demonstrate their compliance with the overall programme. A further limitation relates to the group being evaluated on its own without a comparison group.

This study has important implications for treatment delivery in prisons, as it demonstrates the therapeutic merit of social creative activities for one of the most complex, high-risk and challenging offender groups. The findings show that the specific combination of the physical act of drumming and the social act of drumming together may create an environment that allows people to heal and overcome both physical and emotional disconnections that have been caused by their trauma.

This study’s findings provide further understanding of the experience of people who have survived trauma.

Findings suggest that the group provides therapeutic value, offering an alternative to traditional therapy and targets specific difficulties particularly associated with emotionally unstable and antisocial PDs. We suggest that socially creative activities form an important part of the rehabilitation process of complex, high-risk groups. Future research would benefit from focusing on the extent to which experiential learning through socially creative group participation can impact on lasting behavioural change.

Background: historical assumptions and knowledge about personality disorders (PDs) have inhibited efforts to improve PD services. Public and patient involvement in research has become a requirement of UK health services research. The potential for people with personal experiences of PD to ‘coproduce’ research knowledge as a means to transform PD services is largely unexplored.Objectives: to consider the extent to which research teams on two recent projects have ‘coproduced’ knowledge about PD, and the potential impact of coproduction on research findings and service delivery.Setting: two qualitative research projects were conducted by teams comprising conventional academic, clinical, service user and carer researchers. Reflective writing by researchers was analysed thematically to explore research objectives.Findings: researchers reported that their high expectations of research coproduction were mostly met, that findings would have been different without involvement of service user and carer researchers, and that the research would have wider credibility because of their involvement.Conclusions: coproduction is characterised by enabling perspectives from outside the conventional clinical‐academic health research team to inform the research decision‐making process, and by self‐conscious reflection to make explicit how findings are shaped as a result. The potential to improve PD services by coproducing knowledge was demonstrated.

The purpose of this paper is to describe the pattern of self-harm (SH) and proven prison rule-breaking (PRB) behaviour in prisoners receiving treatment for personality disorders (PDs) within a high security prison.

A comparative quantitative case study design supported the understanding of the frequency and pattern of SH and PRB behaviour across two stages of a PD treatment programme for 74 male prisoners. Data obtained from the prison’s records were analysed using dependent t-tests, χ² test of independence and time-frequency analyses.

Inferential statistics showed that the frequency of SH and PRB behaviour statistically increased across two phases of the PD treatment programme; however, the method of SH or type of PRB behaviour engaged in did not change. Mapping the frequencies of incidents using a time-frequency analysis shows the patterns of both behaviours to be erratic, peaking in the latter phase of treatment, yet the frequency of incidents tended to decline over time.

This is the first study to explore SH and PRB behaviours in men across two phases of a PD treatment programme. This study highlights the need for continued psychological support alongside the PD treatment programme with a focus on supporting men in treatment to effectively manage their SH and PRB behaviour.

This paper describes the clinical and risk characteristics of patients admitted over the first four years of operation of the Dangerous and Severe Personality Disordered (DSPD) NHS pilot at the Peaks Unit, Rampton Secure Hospital. There were 124 referrals, mainly from Category A and B prisons, resulting in 68 DSPD admissions. Clinically, 29% scored 30 or more on the Psychopathy Checklist. The most common personality disorders were antisocial, borderline, paranoid and narcissistic. There is a high risk of violent/sexual recidivism as measured by the Static‐99, Violence Risk Scale, and the Historical, Clinical and Risk Management Scale.

The purpose of this paper is to explore the different clinical features of pathological demand avoidance (PDA) and antisocial personality disorder (ASPD) presented in the form of a single case study. The study highlights the potential of misdiagnosis and conceptual confusions to practitioners in forensic settings between the two conditions when working with offenders with personality disorders.

A case formulation using the “five Ps” method based on the personal history of an incarcerated male is presented and the clinical similarities and differences between PDA and ASPD are delineated. These differences and similarities are evaluated and applied to offender management including intervention options.

There are considerable similarities between ASPD and PDA making the two conditions difficult to separate. Both diagnostic criteria identify childhood behavioural problems, aggression, destructiveness, conduct disorder (CD), manipulation and non-compliance as indications of the disorder. For example, the criteria for later adult ASPD are the presence of childhood antisocial behaviour and CD. However, these behaviours may also be suggestive of the attention deficit hyperactivity disorder and non-compliance that are part of PDA. Violent behaviours and aggression can also be perceived in a similar way. Misdiagnosis of PDA as ASPD reduces the efficiency of treatment programmes.

The implications of these findings could prove useful in the successful risk management of offenders with PDA. Given the similar behavioural characteristics between PDA and ASPD, the prevalence of PDA among offenders may be higher than observed. The aim of this study is to raise awareness of potential conceptual complications and clinical confusions between the two conditions with a view to aid offender management through case formulation. A large scale study into offenders with PDA would draw attention to the prevalence of the condition as well as its association with offending behaviour.